Alleviating Suffering 101 — Pain Relief in the United States
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An Institute of Medicine committee has found that the magnitude of pain in the United States is vast — and costly. It concluded that relieving acute and chronic pain is a significant overlooked problem and that education is key to the cultural transformation required.
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The economic burden of pain in the United States was estimated to be $560-635 billion in 2012.
“the economic burden of pain in the United States was estimated to be $560-635 billion in 2012.10”
From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [10]
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Regulation of pain by neuro-immune interactions between macrophages and nociceptor sensory neurons
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“Chronic pain is a clinical epidemic, affecting more than 30% of adults with costs exceeding $600 billion dollars annually in the United States [4].”
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“Chronic pain costs the US economy more than $600 billion per year in healthcare expenditures, disability payments, and lost productivity (from American Pain Society) (2).”
BackgroundEndogenous adenosine A3 receptor activation selectively alleviates persistent pain states
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“Chronic pain is an enormous unmet medical need with a multi-billion dollar impact on society (Pizzo and Clark, 2012).”
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“Hamburg spoke of “100 million Americans suffering from severe chronic pain,” which became a central part of the debate used to justify Zohydro’s approval (61-63).”
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“Discussion Recently there has been much concern expressed about the over-prescribing of opioids [7,28-30].”
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Hansen, H. (2012) · Pain Physician · doi:10.36076/ppj.2012/15/e247 · Cited by 134 · see citing works
Manchikanti, L., Abdi, S., Atluri, S. L., Balog, C. C., Benyamin, R. M., Boswell, M. V., Brown, K. R., Bruel, B. M., Bryce, D. A., Burks, P. A., et al. (2012) · PubMed · Cited by 129 · see citing works
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“Normalizing nitroxidative signaling may be an alternative strategy to help to alleviate the enormous burden of pathological pain, which affects 20% of the population and is poorly treated [11,193,194].”
Why Doctors Prescribe Opioids to Known Opioid Abusers
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“Figure S7 WHO I drug studies with high level of evidence: SMDs between pain scores (0–100) in treatment (analgesic) and placebo groups at study end, based on published (Pizzo and Clark, 2012) or imputed (i) data.”
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“Current research by the Institute of Medicine (IOM) estimates that chronic pain affects approximately 100 million individuals in the United States (US) and has an estimated societal impact between $560 and $635 billion annually in direct medical treatment costs and lost productivity.(1) Chronic pain, particularly when…”
BackgroundResultInfluentialEffect of Minocycline on Lumbar Radicular Neuropathic Pain
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State Medical Marijuana Laws and the Prevalence of Opioids Detected Among Fatally Injured Drivers
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mTOR, a New Potential Target for Chronic Pain and Opioid-Induced Tolerance and Hyperalgesia
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“People with chronic pain are known to consult health professional frequently, leading in a heavy economic burden [3, 4].”
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mTOR Kinase: A Possible Pharmacological Target in the Management of Chronic Pain
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“Pain, more than any other symptom or disease, is the single greatest source of financial expense and patient complaints in America.63 Reducing the potential for pain from neck dissection, minimizing xerostomia, and using evidence-based strategies for effective analgesia are opportunities worth considering in order to…”
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“Institute of Medicine (2012) stated that a major impediment to adequate pain relief was patients’ limited access to clinicians who are knowledgeable about pain, which was related to the prevalence of outmoded or unscientific knowledge and attitudes about pain.(19) In response, several recommendations have been made to…”
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“…drugs (NSAIDs), antidepressants, anticonvulsants and opioid pain relievers; however, these strategies are frequently either inadequate or are associated with side effects that reduce quality of life or result in the discontinuation of therapy (Goldberg and McGee, 2011; Pizzo and Clark, 2012).”
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“Chronic pain is projected to impact 37% of Americans by 2030, creating an additional economic burden of $635 billion (3, 4).”
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“In addition to significantly affecting patient quality of life, chronic pain has a high economic burden (Crown, 2012; Pizzo and Clark, 2012; Zhou et al., 2016a).”
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“Approximately one-third of Americans suffer from chronic pain, and this proportion is increasing.(41,43) Chronic pain, including neuropathic pain fromperipheral nerve injury, is frequently treated with opioids.”
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“[18] Inadequate knowledge concerning managerial skills and pain assessment[19] and wrong understanding of various professional health caregivers, especially the nurses, have been mentioned as efficient managerial barriers in adequate pain management.[20] Therefore, as pain management is essential for appropriate care…”
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“The combination of two factors related to coping with this problem gives surgery an additional importance: (1) ineffective existing treatments of neuropathic pain and (2) the importance of surgical techniques avoiding nerve injuries in the prevention of this type of chronic pain.”
InfluentialKynurenine Pathway Metabolites as Potential Biomarkers in Chronic Pain
Auyeung, A., Wang, H. C., Aravagiri, K., & Knezevic, N. (2023) · Pharmaceuticals · doi:10.3390/ph16050681 · Cited by 20 · see citing works
“The economic burden that chronic pain places on the United States exceeds the amount spent on the country’s preeminent health conditions of diabetes, cancer, and cardiovascular disease combined [5].”
BackgroundBach‐Rojecky, L., Vađunec, D., Žunić, K., Kurija, J., Šipicki, S., Gregg, R. A., Mikula, I., & Primorac, D. (2018) · Personalized Medicine · doi:10.2217/pme-2018-0116 · Cited by 23 · see citing works
The Internet of Things (IoT) in pain assessment and management: An overview
Prada, E. J. A. (2020) · Informatics in Medicine Unlocked · doi:10.1016/j.imu.2020.100298 · Cited by 23 · see citing works
“Only in the United States, more than half of patients with pain have reported inadequate treatment of their condition [55], and this percentage is even higher in low- and middle-income countries [9].”
BackgroundFuture Directions for Pain Management
Mackey, S. (2016) · Hand Clinics · doi:10.1016/j.hcl.2015.08.012 · Cited by 22 · see citing works
Interprofessional pain education: definitions, exemplars and future directions
Carr, E., & Watt‐Watson, J. (2012) · British Journal of Pain · doi:10.1177/2049463712448174 · Cited by 22 · see citing works
Neoclerodanes as Atypical Opioid Receptor Ligands
Prisinzano, T. E. (2013) · Journal of Medicinal Chemistry · doi:10.1021/jm400388u · Cited by 23 · see citing works
“divinorum leaves identified salvinicins A (6) and B (7).”
Postoperative Pain: Management and Documentation by Iranian Nurses
Rafati, F., Soltaninejad, M., Aflatoonian, M. R., & Mashayekhi, F. (2016) · Materia Socio Medica · doi:10.5455/msm.2016.28.36-40 · Cited by 22 · see citing works
“Negative misperceptions and biases was introduced a preventive factor for the provision of adequate pain control in other studies as well (22) analgesic Drugs Admissions Oral Analgesics Suppository Parenteral parasetamol Intramuscular opioid analgesics Parenteral opioid analgesics Total”
BackgroundDynamic Quantitative Sensory Testing to Characterize Central Pain Processing
Mackey, I. G., Dixon, E. A., Johnson, K. A., & Kong, J. (2017) · Journal of Visualized Experiments · doi:10.3791/54452-v · Cited by 21 · see citing works
Beck, E. C., Nwachukwu, B. U., Jan, K., Krivicich, L. M., Chahla, J. A., Fu, M. C., & Nho, S. J. (2020) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/j.arthro.2020.02.007 · Cited by 20 · see citing works
Chung, K., Ho, C.-H., Chen, Y.-C., Hsu, C.-C., Chiu, C., Lin, H.-J., Wang, J.-J., & Huang, C.-C. (2020) · Pain medicine (Malden, Mass.) · doi:10.1093/pm/pnaa107 · Cited by 19 · see citing works
Dimethyl itaconate inhibits neuroinflammation to alleviate chronic pain in mice
Ren, J., Yu, L., Lin, J., Ma, L., Gao, D. S., Sun, N., Liu, Y., Fang, L., Cheng, Z., Sun, K., et al. (2022) · Neurochemistry International · doi:10.1016/j.neuint.2022.105296 · Cited by 20 · see citing works
Transporter-Mediated Disposition of Opioids: Implications for Clinical Drug Interactions
Gharavi, R. B., Hedrich, W. D., Wang, H., & Hassan, H. E. (2015) · Pharmaceutical Research · doi:10.1007/s11095-015-1711-5 · Cited by 19 · see citing works
- Authors
- Pizzo, P. A., & Clark, N. M.
- Affiliations
- Stanford Medicine (US)
- University of Michigan (US)
- ORCID
- Pizzo, Philip A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2012-01-19
- Volume
- 366
- Issue
- 3
- Pages
- 197-199
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2072724964
- Cited by
- 231
- References
- 0
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 9 · 2023: 13 · 2022: 10 · 2021: 16 · 2020: 16 · 2019: 12 · 2018: 17 · 2017: 16 · 2016: 16 · 2015: 25 · 2014: 20 · 2013: 21 · 2012: 27
- FWCI
- 40.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- analgesia, chronic pain, acute pain, pain management, Institute of Medicine report, pain education, cultural change, health care costs, United States
- MeSH terms
- Clinical Competence, Education, Medical, Humans, United States, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Advisory Committees, Chronic Pain, Pain Management
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