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In the context of the opioid crisis, doctors discuss the future of chronic pain treatment

The opioid crisis is so challenging in part because the drugs are often prescribed for legitimate reasons.
The opioid crisis is so challenging in part because the drugs are often prescribed for legitimate reasons.
Photo by Ian Sheddan via Flickr Creative Commons

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Opioid addiction has reached the level of public health crisis in America, necessitating a shift in how medical professionals approach their patient’s pain.  

The recent Vox article “The opioid crisis changed how doctors think about pain” traces the push in the 1990’s for doctors to take their patient’s pain more seriously, even elevating it to a vital sign, which coincided with pharmaceutical companies pushing opioids.

The subsequent opioid crisis has reversed the thinking about this painkiller’s efficacy and safety, but it has also spurred larger questions about the medical profession’s approach to pain.

In 2015, Dr. Jane Ballantyne co-wrote a controversial article that argued for a more pragmatic paint treatment approach, with a focus on a person’s function rather than the elimination of their pain.

As argued in the aforementioned Vox article, the medical profession has largely shifted towards her thinking. Subsequently, there have been calls for more transparency regarding medication, for changing patients’ overly-optimistic expectations regarding pain treatment and for more holistic approaches to pain, as well as concern that pain won’t be treated as effectively now.

Against the backdrop of the opioid crisis, we sit down with three doctors to explore the rise of opiates, and how pain treatment can move past them. What roles did a shifting approach to pain play in the rise of the opioid crisis? How should patients and doctors approach chronic pain treatment? And listeners, what conversations have you had with doctors and which approaches have you undertaken regarding chronic pain?  


Anna Lembke, M.D., program director for the Stanford University Addiction Medicine Fellowship and Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic; her latest book is “Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop” (Johns Hopkins University Press, October 2016)

Jane C. Ballantyne,  M.D., Professor, Anesthesiology and Pain Medicine at the University of Washington; she co-wrote the 2015 New England Journal of Medicine Article “Intensity of Chronic Pain – The Wrong Metric?

Michael Clark, M.D., vice chair for clinical affairs and director of the pain treatment program in the department of psychiatry and behavioral sciences at the Johns Hopkins Hospital