Happy New Year SPS Membership!
It is with excitement that I look forward to the new year of 2017. But also some sadness as I step away from the role as president. It has been a wonderful two years with the organization serving in this role. As I reflect back on my time served, I marvel at what has happened both within the society and within health care as a whole during my term.
One major development of growth during the time of my presidency was a much greater attention to mental health in the problem of chronic pain. As a pain psychologist, this is a movement I watch with great interest. I hope our membership noticed it as well, because it has been truly revolutionary. I have been practicing a dozen years, and in the last 2 years there has been a real excitement around pain psychology. There have been many more peer reviewed articles discussing the use of psychological self-care strategies, meditation, relaxation and the importance of educating the person with pain about what pain is and what chronic pain is not.
In March of 2016, the CDC guidelines also emphasized the use of mental health, specifically psychology and the use of cognitive behavioral therapy as alternatives to opioids as first line treatment for chronic pain. The CDC pointed to research showing that cognitive behavioral therapy, mental health counseling, or even a combination of these with nonopioid treatments (e.g. acetaminophen, non-steroidal anti-inflammatory drugs, physical therapy) were effective ways to decrease the risk of opioid co-dependence and potential death.
The mental health provisions of the “21st Century Cures Act,” signed by President Obama in December 2016, establishes several new milestones for mental health. A new assistant secretary for mental health in the Department of Health and Human Services will be placed, as well as a chief medical officer, which elevates behavioral health in the context of overall health policy. This is sorely needed! The Cures Act also provides funding for grants in critical areas like suicide prevention and to address the nation’s critical opioid crisis.
Perhaps most powerfully, the provisions of the Cures Act aims to provide stakeholder education and protect consumers by ensuring compliance with existing laws, specifically, the Mental Health Parity and Addiction Equity Act, both of which are designed to prevent health plans from imposing less favorable benefits for mental health and substance abuse disorders than for medical and surgical benefits.
This year, Beth Darnall, PhD, a pain psychologist at Stanford, will be discussing self management strategies for chronic pain at the American Academy of Pain Medicine Meeting in Orlando, and will be hosting an innovative panel discussion about using these techniques directly with pain patients in any setting. Dr. Darnall has been very active in bringing pain psychology to the public eye through her media presence, her research at Stanford with Sean Mackey, MD, PhD, and her books “Less Pain, Fewer Pills,” and “The Opioid Free Pain Relief Kit”.
This past November 2016, I was very encouraged to see several talks dedicated to the biopsychosocial model and the topic of “Mental Health and Pain”, at a national worker’s compensation conference. Even just hearing the words “mental health” at an industry / carrier conference was so refreshing I almost stood up from my seat and clapped! For any of you who have treated personal injury claimants, you realize what a long time this is in the making. It is very important that industry and insurance companies recognize the value of mental health and how to rehabilitate the whole person with pain, because they are the lynchpin of reimbursement and service delivery.
At SPS, we are doing our part on a regional level to broaden our scope of teaching pain management from both a mental health and medical perspective. I was overjoyed to bring Dr. David Hanscom (www.backincontrol.com) to the SPS 2016 meeting. The response to him from our membership was so incredible. We had so many attendees tell us how valuable hearing his perspective was, from hearing about his own journey as a neurosurgeon, as well as someone with pain, to them as providers. I have recently begun partnerships with several primary care providers in my own area, where we co-treat patients, using the philosophy of Dr. Hanscom, as well as ideas directly from cognitive behavioral therapy. It is so exciting how we have significantly changed these patient’s lives. I recently co-treated a patient who attended very brief cognitive behavioral treatment and three sessions with his primary care provider. The patient has been using the tools of cognitive behavioral therapy as well as Dr. Hanscom’s book. The patient has experienced over a 50% reduction in pain without a single medication change. Cases like these challenge us to rethink our approach to chronic pain. We are now working on a weaning regimen for his medications in light of his recent gains. Incredible!
We have been faced with many challenges in the last two years. The opioid epidemic, insurance coverage changes, the large number of chronic pain patients needing to be seen, and the lack of pain specialist access. These are all issues that we as a Society will continue to make a priority as an organization and brainstorm solutions that help our Frontline providers. We are working to forge new interdisciplinary relationships to address the ever-present treatment challenges in pain. As further evidence of this, our 2017 meeting “Head to Toe,” SPS is partnering with the Southern Headache Society (SHS), an organization of primarily neurologists, to share ideas and innovations in head pain and beyond. It is very rewarding to see this collaboration come to fruition after two years of hard work!
I hope that these stories inspire you as they have me. I hope you continue to attend our meetings. Please continue to challenge us and stimulate us with your feedback and topics of Interest. I look forward to the partnership with the southern headache society that has been germinating for several years. It will be truly an exciting time in New Orleans this fall. Look for me and I will be looking for you! As always reach out if you have questions or feedback.
Geralyn Datz, PhD