Guest Columns

America should talk about chronic pain

Share this content:
Penney Cowan, American Chronic Pain Association
Penney Cowan, American Chronic Pain Association

Chronic pain is a major health problem in America and it is well documented that many residents of long-term care facilities live with pain. In 2011, the Institute of Medicine published a report, Relieving Pain in America. The report stated that there are more than 100 million people living with some form of pain. While each person may experience his or her pain differently, one thing is certain, they all want to feel better yesterday.  

There are a multitude of treatments and therapies that can help a person improve the quality of life and increase function while reducing suffering. There is no simple treatment that will alleviate a person's pain. It takes a combination of therapies as well and the involvement of the person with pain to live a full life in spite of pain.  Good pain management with the person with pain at the center is key to moving forward. For many there may always be some level of pain, but it is possible to regain control of life as long as the person with pain is involved in his or her treatment.  

For a person in a long-term care facility, many of them older adults, it can be especially difficult to manage pain. Many have a difficult time communicating their pain, how it feels, sometimes even where it hurts. There are some who will act out because of pain but it may not be obvious to the staff what is really wrong. Because pain is invisible, it cannot be measured, seen or felt by anyone other than the person experiencing it, which can make it difficult to understand. For those who can express their suffering, it can be challenging to provide all the components of pain management necessary to reduce their suffering.  

Many healthcare providers lack the knowledge to provide a multifaceted treatment plan to the patient. One of the first options for treating long-term pain is with opioid medication. Older adults often react differently to these medications, especially those over the age of 65. Some are on a number of medications for other ailments and opioids are not always compatible with some medications. In these cases an opioid emergency can happen. The staff needs to know what to look for and how to respond quickly.  

On average, 44 people die each day from prescription opioids. Sadly, more than 80% of deaths due to prescription opioids are unintentional. For older adults, the risk is higher. Needless deaths can be avoided if staff members know what to do.   

It is for this reason the America Starts Talking is such an important campaign.  It brings a simple message of how to intervene, in case of an opioid emergency, whether in a long term care facility or right in the living rooms of America. It is designed to help anyone understand the importance of knowing the signs of an opioid overdose and ways to react if needed. Key components of America Starts Talking are:

  • Having a conversation with your healthcare professional at the time of receiving a prescription about how to store and use the medication appropriately.
  • What questions you should ask your health care providers about taking the mediation.
  • Understanding exactly how to take it and how often you should take the medication.
  • What can you do if an opioid emergency happens.
The America Starts Talking campaign is designed to provide information about naloxone, a potentially lifesaving medication that can be used in an opioid emergency. Most people think that they will never be faced with such an event as an opioid emergency, but it can happen to anyone, anytime, anywhere, even in a long-term care facility.  It will be the quick action that can mean the difference between life and death. Having naloxone available so that the person can react immediately can help save a life.    

It is the unintentional deaths that can hopefully be prevented by understanding the symptoms of an opioid overdose such as slow breathing, pale skin and being unresponsive that is the focus of the America Starts Talking campaign.  The more people know, the better prepared they will be to react.  

The website of helps staff at long-term facilities give patients and their family members easy-to-understand information. There is a quiz to test knowledge about symptoms of an overdose. It will help patients, their families and staff members understand the importance of taking an opioid medication as directed. The site will explain interactions with other medication and how to respond quickly.

When using an opioid as part of a pain management treatment, it is important to share with families and patients a few important facts:

  • use them as directed   
  • store them in a safe place and make sure that when these medicines are dispensed, they are taken and not left on the nightstand  
  • do not share them with anyone ever
  • Check  all prescription and over the counter medication the patient is taking before giving opioids to prevent interaction
  • don't mix alcohol with opioid medication
  • visit to learn what to do in an opioid emergency
America Starts Talking provides the information needed to help prevent unnecessary death while educating about what one needs to know in case of an opioid emergency. It will be information that can help save a life if a patient is taking an opioid as part of their pain management regimen.  Isn't it worth a few minutes of your time to learn more about what to do if you are faced with an opioid emergency?  I think it can be priceless.  You just never know what might happen, even in long term care facilities.  

Penney Cowan is the founder and executive director of the American Chronic Pain Association.



Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.