The Challenge - Pain Management
Like their colleagues in every other part of the United States, Berkshire County healthcare providers face the challenge of assuring that effective and appropriate pain management remains available to those who need it while, at the same time, combating misuse and diversion of pain medication.
According to Department of Public Health data, physicians and other healthcare providers in Berkshire County write prescriptions for millions of opioid tablets every year, along with other pain medications and treatments. Most of that medication is prescribed appropriately and taken appropriately. However, some patients receiving prescriptions for opioid tablets may benefit from other, non-pharmaceutical interventions, either in combination with or instead of drug therapies. In many cases, complaints of chronic pain are accompanied by or associated with conditions that may respond well to assessment and intervention by specialists in rehabilitation medicine, rheumatology, neurology, neurosurgery and behavioral health or substance abuse services. Although a full spectrum of services for the assessment and treatment of chronic pain is available locally, those services have not been as well-coordinated as they could be or made easy for Berkshire County healthcare providers to draw upon for the benefit of their patients. The general health and well-being of many in our communities might significantly improve if all healthcare providers in Berkshire County who manage patients with chronic pain had ready access to the wealth of knowledge and experience of those physicians and other providers whose specialties include issues associated with chronic pain management.
The health and safety of our communities would also be enhanced if healthcare providers had information and tools immediately at hand that would help them recognize and respond effectively to situations of actual or threatened medication abuse or diversion. As in every other part of the country, prescription medications are becoming increasingly popular street drugs throughout Berkshire County, including among high school and middle school students in cities and towns from North Adams to Southfield. An insidious black market in prescription pain medication has taken root throughout the area, fueled, in significant part, through prescriptions issued by unwitting Berkshire County healthcare providers. As in other regions of the United States, Berkshire County has recently seen a marked rise in prescription drug-related overdoses, emergency room visits and deaths.
Berkshire Health Systems, its various departments and physician practices, together with the community physicians and other providers on its hospitals’ medical staffs, are uniquely situated to accomplish the twin goals of improved service and diminished misuse and diversion. However, maintaining quality pain management services for those who require them and minimizing misuse and diversion of pain medication both require an efficient and timely means of sharing appropriate information among healthcare providers and an effective coordination of consulting and referral services. For that reason, Berkshire Health Systems has sponsored the Community Pain Management Project, a multi-disciplinary and multi-agency effort to develop information and other tools, including those reflected in this volume, the Pain Care Resource Manual: A Practical Guide for Health Care Professionals.