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Pain Management and Opioid Addiction
A Q&A with Kim Mauer, MD and Kirsten Langdon, PhD
By Christie VanHorne, M.Ed, MPH
Pain is a complex subject and has been the center of con- cutaneous Electrical Nerve Stimulation) units and referrals for
tentious conversations amongst medical professionals for physical therapy, massage therapy, acupuncture, biofeedback,
decades and a topic of conversation familiar in many Ameri- yoga, mindfulness training, and so on.
can households. A 2015 analysis of data from the 2012 National
Health Interview Survey (NHIS) found that an estimated 25.3 What do you do at a CPMC?
million adults had pain every day for the preceding 3 months.
The bleeding disorders community is all too familiar with the The objective is to provide goal-oriented treatment with state-
findings of NHIS’s report, having many in the community who of-the-art, non-surgical treatments for back, neck and extremity
suffer with pain on a daily basis, year-round. pain as well as headaches and facial pain. The pain center is a
provider-referred pain clinic where patients collaborate in their
Given the nation’s ongoing opioid crisis, the topic of pain man- treatment planning.
agement and its potential path to addiction is at the forefront
of media and legislative bodies across the country. In early Au- What’s the difference between acute and
gust, the White House opioid commission released an interim chronic pain, and how they should be
report that calls on President Trump to officially declare the managed differently?
opioid crisis a national emergency. The commission empha-
sized the fact that 142 people in the US die each day of drug Acute pain is pain that is expected to subside within three
overdose. months. It should be managed with opioids if the pain is no-
ciceptive in origin, that is, caused by damage to body tissue,
We sat down with Kim Mauer, MD, who specializes in pain or perhaps even if it is acute neuropathic pain, which occurs
management, and Kirsten Langdon, PhD, an addiction special- when there is actual nerve damage. Optimally, opioids should
ist, to discuss these topics and how they impact the bleeding be limited if the pain moves from acute to chronic. Chronic
disorders community. pain should be managed with a multimodal, interdisciplinary,
alternative therapy approach. Examples of multimodal, inter-
Dr. Kim Mauer disciplinary, alternative therapy can include acupuncture, chi-
ropractic, massage therapy, nutritional therapy, physical thera-
What is a Comprehensive Pain Management py, biofeedback, hypnosis and many more.
Center (CPMC)?
A Comprehensive Pain Management Center should offer many A pain sufferer’s mood must be monitored very closely in both
treatment options for pain. Options should include non-opioid acute and chronic pain situations because pain and mood
medications such as anti-inflammatories, muscle relaxants, are processed in the same areas of the brain. It’s kind of like
or neuropathic agents, indicated interventional procedures, a “chicken and egg” scenario. If we don’t improve mood, pain
non-medication/non-injection options, such as TENS (Trans- doesn’t improve, and without improving pain, it is difficult to
improve mood.
16 Dateline Federation | Fall 2017
