Pubdate: Sun, 15 Jul 2001
Source: Sun News (SC)
Copyright: 2001 Sun Publishing Co.
Contact:  http://web.thesunnews.com/
Details: http://www.mapinc.org/media/987
Author: Dr Stephen G Gelfand

AREA NEEDS MORE TREATMENT PROVIDERS

Perhaps the closing of a local pain clinic associated with the spread of 
OxyContin abuse in this area, as well as nationally, can help generate a 
needed dialogue in both medical and community circles about non-drug 
approaches to chronic nonmalignant pain. OxyContin was originally developed 
for and is very effective in the treatment of cancer and other types of 
severe intractable pain. However, it and similar narcotics have frequently 
been prescribed for other types of chronic nonmalignant pain, including 
conditions associated with chronic stress (whether recognized or not). This 
has increased the supply and availability of OxyContin, contributing to the 
current problem. Unfortunately, those who truly need this drug may find it 
difficult to obtain, while those who do not run the risk of habituation or 
addiction, to which the many gradations of stress predispose. Numerous 
studies have documented the association between chronic pain and persistent 
chronic stress, which may be related to neurochemical imbalances in the way 
the brain and body process the mental component of stress. This has lead to 
a resurgence of interest in the benefit of non-pharmacological 
self-directed, active patient participation techniques such as Stress/Pain 
management programs which utilize behavioral-cognitive therapies and other 
Mind/Body methods that attenuate the chronic stress response. Included in 
these types of treatments are patient education and exercise programs, 
relaxation techniques, cognitive restructuring, as well as self-help 
courses and psychological counseling when indicated. Such strategies 
involve lifestyle changes and are time- and effort-consuming, but provide a 
healthier alternative to drugs with long-lasting benefits if initiated 
early and maintained over time. Even though improved outcomes have occurred 
with less reliance upon drug therapy, these important self-management 
aspects of chronic pain treatment have often been neglected or downplayed 
by many pain clinics. We can no longer afford to have a one-size-fits-all 
approach to chronic pain. The different origins of these conditions need to 
be recognized, diagnosed and treated early, especially since refractoriness 
to treatment is often associated with duration of symptoms. In this region, 
there is a need for more behavioral health providers [including those 
trained in the latest Mind/Body techniques], health educators, and 
instructors of exercise and other self-management programs. The lives of 
many patients within the spectrum of chronic nonmalignant pain can be 
improved, while dependence upon potentially addicting drugs in these 
vulnerable individuals, as well as illegal substance abuse, substantially 
reduced. The writer is from Myrtle Beach.
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MAP posted-by: Larry Stevens