3rd August, 2019
By Lynn Webster, M.D.
This article, in a slightly edited form, first appeared on Pain News Network on August 3, 2019.
The National Institutes for Health (NIH) has published a Request for Information (RFI) that seeks input from “stakeholders throughout the scientific research and medical education community and the general public regarding the Centers for Excellence in Pain Education (CoEPEs) educational content regarding treating pain and opioid misuse or use disorder.”
Although the NIH is asking healthcare professionals to weigh in, comments from the general public are also welcome. If you are a person in pain, or love someone who is, your input is what all healthcare providers should hear.
You can see the RFI—Guidance on Current Education Curricula for Health Care Professionals Regarding Pain and Opioid Misuse and Use Disorder, here, or below. The link includes an email address to use to contribute your thoughts.
This is an opportunity to tell the NIH what you would like to see included in pain education, or what needs to be taught regarding opioid misuse or abuse, from your perspective. People often want to be heard. This is the time to let the NIH know what you believe is important to teach all healthcare providers.
Potential educational topics could include:
- What you feel should be the primary goal of pain treatment
- The role of empathy, rather than animus, in treating people with pain
- The power of trust, rather than suspicion and disbelief, in the therapeutic relationship
- Techniques to reduce the stigma of pain, disability, and opioid use disorder
Therapies of the Heart
My comments to the NIH will include some of my strongly-held beliefs, including:
Pain therapy must include compassion. A therapeutic relationship may not be considered mainstream medical treatment, but it is crucial to pain management. It includes acceptance, compassion, listening, respect, encouragement, trust, kindness, patience, and being fully present.
I call these the therapies of the heart. They are simple, yet vital, components of a broad-based approach to treating the whole person.
Too often, people in pain are abandoned by health care professionals, family members, and friends. They need to be supported by all the key people in their lives and treated by medical professionals who are adequately trained.
Education should convey that pain isn’t just biological. It is psychological, social, and spiritual. A healthcare professional who treats pain must internalize this concept to provide the most humanistic treatment possible.
The fact that withdrawal does not mean addiction is a concept too few people in healthcare understand. Any education that discusses opioids must make clear the differences between addiction and withdrawal. Providers also must learn that a person who experiences withdrawal is not necessarily addicted.
I will recommend to the NIH that their program require all participants watch Travis Rieder’s TED Talk. I will ask that their curriculum make it clear that babies cannot be born addicted. The fact that the media commonly uses the phrase “addicted babies” in place of “babies with neonatal abstinence syndrome” only reinforces the misunderstanding of what clinical withdrawal means.
Additionally, education should address misconceptions about people in pain, and how chronic pain affects families and other relationships. Educational content should include a discussion of the losses that accompany chronic pain—to the person in pain, and also to their family members.
Providers need to be trained to understand that pain is personal and individualized; therefore, treatment must be individualized, too. What works for one person may not work for another.
Here is the RFI in its entirety.
iCareTalk.net 