Just published my latest post in Psychology Today: “Empowered Relief: Meeting the Needs of a Nation in Pain.”

In this article I highlight the benefits of integrated pain care, and how brief and digital behavioral medicine treatments can empower patients, expand access to whole-person acute and chronic pain care.

It’s an exciting time with much national focus on pain care. In 2016, the U.S. Health and Human Services published the National Pain Strategy [1] (NPS; co-chaired by Chief of the Stanford Division of Pain Medicine Dr. Sean Mackey and Dr. Linda Porter from NIH). The NPS called for better integration of behavioral medicine strategies broadly into pain care.

However, we have lacked the resources to broadly scale behavioral medicine to meet the needs of Americans who need relief. Of course, the dire need for scalable and low-cost pain treatments is a global problem. At Stanford and beyond, we are working on solutions that bring behavioral medicine forward to the people. The best pain treatments in the world matter little if people cannot access them. The issue of the day is access to individualized care.

We need the full toolbox of options available to patients, and for healthcare clinicians to apply good discernment and medical decision-making as to which treatment option is right for which patient. As you may know, I have strongly advocated for patient access to opioid medications for those who require the opioid analgesia for chronic pain [2-8].

Medical treatment for pain and behavioral medicine for pain are not an “either/or”. It’s both. Patients deserve access to comprehensive pain care, including evidence-based behavioral medicine that is delivered in accessible and convenient ways. We need to meet patients where they are.

At Stanford, we are developing and researching treatment options that enhance patient access to behavioral medicine treatment options, some of which I detail in the post. These include a digital treatment option for surgical patients (“My Surgical Success”) [9], virtual reality for acute and chronic pain [10], and a single-session 2-hour skills-based pain class (“Empowered Relief”) that was cited by the U.S. Health and Human Services Pain Task Force [11] as being a promising and scalable option to deliver whole-person pain care to people with chronic pain.

To date, “Empowered Relief” has been received by more than 2,000 patients and family members nationally and internationally. “Empowered Relief” has been part of clinical care at Stanford Pain since 2013. In 2019, Dr. Ziadni and I launched “Empowered Relief” healthcare instructor certification workshops so that clinicians and healthcare organizations could embed this protocolized treatment into healthcare systems. To date, “Empowered Relief” is delivered in multiple healthcare organizations in the U.S. and Canada, and it is active in the U.K., Denmark, and Australia.

At Stanford, we have two active NIH grants to study “Empowered Relief” outcomes and our Canadian colleagues received national funding to embed “Empowered Relief” into primary care clinics in Canada and study patient outcomes. In November 2019 I conducted a certification workshop in Montreal and another takes place in June 2020. We hope that this international partnership will see us treating pain best by treating it comprehensively and as early in the process as possible. One of our favorite aspects of “Empowered Relief” is that friends and family members are welcome to attend the class, learn more about pain and the skills people can apply to best manage it, and how to best support their loved one who has pain.

Read the Psychology Today full post here.

References:

  1. S. Health and Human Services Interagency Pain Research Coordinating Committee. The National Pain Strategy. 2016.
  2. Darnall BD. The National Imperative to Align Practice and Policy with the Actual CDC Opioid Guideline. Pain Med. 2019 July 23.
  3. Darnall BD, Juurlink D, Kerns R, et al. International Stakeholder Community of Pain Experts, Leaders, Clinicians, and Patient Advocates Call for an Urgent Action on Forced Opioid Tapering. Pain Medicine, Volume 20, Issue 3, 1 March 2019, Pages 429–433.
  4. Darnall BD. “Addressing the Dual Crises of Pain and Opioids: A Case for Patient-Centeredness in Pain Research and Treatment”. October 31, 2018.
  5. Darnall BD. Applause for the CDC opioid guideline authors. The Hill. April 26, 2019.
  6. Darnall BD. Invited Speaker. Congressional Briefing on the “Opioid Crisis Response Act of 2018”. Bipartisan, open session featuring three invited expert speakers. Capitol Hill; Washington D.C. October 2, 2018.
  7. Darnall BD. Invited Speaker. Congressional Briefing on the value of patient-centered research. Darnall spoke on patient-centered methods within the context of pain and opioid use. Bipartisan briefing. Alliance for Health Policy. Capitol Hill; Washington D.C. May 29, 2019.
  8. Darnall BD. Invited speaker, U.S. Food and Drug Administration (FDA) public advisory committee of the FDA Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC) pertaining to high-dose opioid prescribing and de-prescribing. Talk title: “Patient-Centered Opioid De-prescribing.” Washington, DC. June 11, 2019.
  9. Darnall BD, Ziadni MS, Krishnamurthy P, Mackey IG, Heathcote L, Taub CJ, Flood P, Wheeler A. “My Surgical Success”: Effect of a Digital Behavioral Pain Medicine Intervention on Time to Opioid Cessation After Breast Cancer Surgery—A Pilot Randomized Controlled Clinical Trial. Pain Med. 2019; 20(11): 2228–2237. (open access)
  10. Darnall BD, Krishnamurthy P, Minor JG, Tsui J. Randomized Controlled Trial of At-Home, Skills-Based Virtual Reality for Chronic Pain. JMIR Formative Research. 2019 Dec 3 (preprint; in review).
  11. U.S. Department of Health and Human Services (2019, May). Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations.