Law Change Helps Patients Fighting Chronic Pain In Minnesota

August 8, 2022 / Thomas Cohn, MD

A number of new laws went into effect on August 1, but one law in particular could be a godsend for certain chronic pain patients in Minnesota. The law clarifies and updates how doctors can prescribe medications to patients battling chronic pain, which will make it easier for some patients battling complex pain problems to receive the medications they so desperately need.

The new law came after some concerns developed in the wake of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. Those guidelines really attempted to reduce opioid addiction and overdose deaths by placing limits and restrictions on the types of medication that patients with chronic pain could receive. However, as we’ve talked about on the blog in the past, chronic pain is highly individualized, so attempting to paint all pain patients with a broad brush stroke and subject them all to the same restrictions was bound to cause problems for some patients.

The 2016 guidelines featured specific numeric thresholds for opioid prescribing, which were later adopted widely and used in regulations and state laws to police opioid prescribing. But these restrictions also had an unintended effect – patients who could no longer get the crucial medication they needed to help with their pain would sometimes turn to the streets for painkillers.

“Many have turned to the streets out of desperation,” said Laura Johnson, a chronic pain patient who spoke to the Minnesota Senate during a spring hearing. “Many more have ended their lives.”

Both the American Medical Association and the Minnesota Medical Association backed up Johnson’s testimony, sending letters in support of a proposed change.

The New Guidelines

The updated guidelines essentially allow doctors more freedom to continue prescribing opioids past the previous threshold so long as they are doing so with a clear purpose and accurate documentation. The revised statute provides new or updated definitions for treating problems like intractable pain, palliative care and other rare conditions. Here’s what they say:

No physician, advanced practice registered nurse, or physician assistant shall be subject to disciplinary action by the Board of Medical Practice or Board of Nursing for appropriately prescribing or administering a controlled substance in Schedules II to V of section 152.02 in the course of treatment of a patient for intractable pain, provided the physician, advanced practice registered nurse, or physician assistant keeps accurate records of the purpose, use, prescription, and disposal of controlled substances, writes accurate prescriptions, and prescribes medications in conformance with chapter 147 or 148 or in accordance with the current standard of care.

No physician, advanced practice registered nurse, or physician assistant, acting in good faith and based on the needs of the patient, shall be subject to disenrollment or termination by the commissioner of health solely for prescribing a dosage that equates to an upward deviation from morphine milligram equivalent dosage recommendations or thresholds specified in state or federal opioid prescribing guidelines or policies, including but not limited to the Guideline for Prescribing Opioids for Chronic Pain issued by the Centers for Disease Control and Prevention and Minnesota Opioid Prescribing Guidelines.

Prescribers are prohibited from tapering a patient’s medication dosage solely to meet a predetermined dosage recommendation or threshold if the patient is stable; is experiencing no serious harm from the level of medication prescribed, and is in compliance with treatment plan and patient-provider agreement.

No pharmacist, health plan company or pharmacy benefit manager shall refuse to fill a prescription for an opiate issued by a licensed practitioner authorized to prescribe opiates solely based on the prescription exceeding a predetermined morphine milligram equivalent dosage recommendation or threshold.

Prescribers and patients are required to enter into an agreement that includes the patient’s and prescriber’s expectations, responsibilities, and rights according to the best practices and current standard of care with agreement to be signed by the patient and the prescriber, and a copy of the agreement included with the patient’s medical record and a copy to the patient, to be reviewed at least annually and when there are any changes to treatment plan.

Absent clear evidence of drug diversion, nonadherence with the agreement must not be used as the sole reason to stop a patient’s treatment with scheduled drugs.

These updated guidelines should ensure that patients and providers who are doing everything in their power to correctly address a chronic pain issue won’t run into problems with access to medications that they need. Hopefully we see these intended results in the near future. And if you need help with a pain issue in the greater Twin Cities area, reach out to Dr. Cohn and his team today at (953) 738-4580.

In Pain, Stigmatized and Unsupported – What It’s Like To Have Chronic Pain in 2022

August 4, 2022 / Thomas Cohn, MD

As technology advances and we get a better understanding of the underlying causes of chronic pain, you’d think we’d be able to put up a better fight against the debilitating condition. However, a recent survey from the U.S. Pain Foundation uncovered the true landscape of what it’s like to have chronic pain in 2022. Needless to say, we have a lot of work to do in addressing the problem.

The Current Chronic Pain Landscape

For their survey, the U.S. Pain Foundation interviewed 2,275 patients with chronic pain, 72 caregivers and 31 health care professionals to better understand the health care crisis that is chronic pain. The results revealed that for many people, pain is significant, and they don’t know where to turn for support. Here’s a look at a number of the findings from the survey.

On a scale of 1-10, more than half of respondents (52%) rated their average pain level a 7 or higher.
99% said that their chronic pain condition restricted their ability to engage in routine activities.
Only 18% were employed full-time.
79% said they felt stigmatized because of their pain, and 63% said they felt stigmatized by their provider.
1 in 4 patients said they rarely or never had their feelings validated or listened to by their provider.
79% of respondents currently take prescription medications, and 77% felt that it was the most helpful treatment for their pain.
49% of respondents said cost of services was their leading barrier to treatment.
41% of people with pain said they felt their insurance coverage decisions were driven by cost, not what was in their best interest medically.

There’s a lot to sift through in this report, but it provides a pretty rough outlook on chronic pain in 2022. A couple of the biggest takeaways that we want to touch on are in regards to:

Pain – Chronic pain is a condition that affects millions of Americans, but it seems unlikely that people realize just how painful these conditions can be. With more than half of people rating their pain at a 7 or higher, it’s clear that pain isn’t just bothersome or uncomfortable, it’s downright painful. We need to work on lessening pain scores.

Stigma – Fighting the stigma of chronic pain has been one of our top priorities. We pride ourselves in giving each patient the full time and attention they deserve to really understand their pain and how it’s affecting them. By doing this, we believe we’re better able to match patients to active treatments like physical therapy, exercise, breathing techniques or mindfulness training to help overcome their individual issue.

Treatment – As we’e said countless times on the blog in the past, medications can absolutely play a pivotal role in helping you overcome a chronic pain condition, but they shouldn’t be a standalone option. While the report did mention that multidisciplinary approaches were common, it’s a bit concerning to see that 77% felt that it was the best treatment for their pain. It’s possibly the best treatment for their symptoms, but it’s unlikely to be the best treatment for their underlying issue. Hopefully patients are taking advantage of the symptom relief provided by medications to pursue other endeavors like exercise or physical therapy to also attack the root issue of their pain disorder.

If you want someone who won’t make you feel stigmatized and will be a resource for you on your road to recovery from chronic pain, reach out to Dr. Cohn and his team today at (952) 738-4580.

When You Don’t Have Time For Chronic Pain

July 14, 2022 / Thomas Cohn, MD

Nobody has time for a chronic pain condition, but for busy individuals who try to push through the pain to get on with their day, taking the time to appropriately treat their condition may be the first item that they skip when they are trying to plan their hectic schedule.

You may even convince yourself that you don’t have time to receive treatment for your chronic pain because between getting the kids to school, working, planning dinner and doing chores around the house, there simply aren’t enough hours in the day.

If this sounds like your life, this blog is for you. Below, we explain how you can work to improve your chronic pain condition when you’re struggling to find the time to treat it.

Treating Chronic Pain On A Bust Schedule

Here are some tips for how you can work towards a healthier version of yourself and treat your chronic pain condition when you don’t have a lot of extra time to spare.

1. Incorporate More Movement In Your Life – Movement is wonderful for your body and your chronic pain condition. Activity helps to strengthen muscles, boost your circulation and avoid weight gain that can further stress your body. Find little ways to become more active throughout the day if you find it hard to get to the gym for a full workout. Take the stairs over the elevator, park further away from the entrance to work or the grocery store, or walk around while you’re on a phone call or waiting for your kids to finish soccer practice. Strive to take more steps every day.

2. Make The Time – This is obviously easier said than done, because you can’t physically create more hours in the day, so any time you carve out for physical therapy or exercise will come by sacrificing something else. Our best advice here is to make 15-20 minutes each day where you turn off all the distractions and focus on yourself and your health. That may mean waking up 15 minutes earlier, staying up a little later, or simply having a conversation with your family about how you need a few quiet minutes after dinner to focus on yourself and your health. Finding just a few minutes each day where it’s only about you will do wonders for your physical and mental health.

3. Improve Your Diet – Your diet can help or hurt your chronic pain treatment, so make some simple adjustments to ensure it’s working to solve your chronic pain. Busy people can sometimes over-rely on unhealthy options like fast food or flash frozen options. Meal plan for the week or take a few minutes each night to prep your meals for tomorrow so that you know where your meals are coming from and you can make healthier choices. Also, consider investing in a water bottle so that you can always stay hydrated when you’re on the go, as dehydration can lead to blood pressure issues and muscle pain.

4. Reevaluate Your Priorities – We understand that exercise and physical therapy may not be the most fun thing in the world, but few things are more important than your health, so you’ll want to keep that in mind when you’re planning your day. Really start to get in the habit of making time each day for your health, and soon it will become easier to follow through with your exercises as you develop a routine. Make sure your priorities are in the right order.

5. Connect With A Professional – Finally, if you’re too busy to fight your chronic pain condition on your own, enlist a professional. A pain specialist can figure out what’s going on, develop an individualized care routine and may even be able to see you through a virtual visit so that you don’t have to take time driving to and from the clinic. Let a professional make sure that you get the most out of the limited time you have to commit to a pain management program. In the greater Twin Cities area, connect with Dr. Thomas Cohn for help with your chronic pain problem. Give his clinic a call today at (952) 738-4580.

How Can We Do More For Chronic Pain Patients?

July 7, 2022 / Thomas Cohn, MD

Chronic pain affects more than 50 million people in the US alone, and yet it doesn’t seem to be an issue that is getting the attention it deserves. We need to be doing more for the millions of people who battle a chronic pain diagnosis on a daily basis, but how can we provide better care?

We don’t pretend to have all the answers, but we’re going to use today’s blog to talk about some of the ways that pain care in America and across the globe could be improved.

Solving Chronic Pain On An Individual Level

Let’s first look at the problem on a local level. What can a pain care physician do to help solve chronic pain? They need to focus on what they can do to provide the best level of care to the patients they are seeing in their office. This involves:

Taking the time to listen – Everyone’s pain is different, and there are no one-size-fits-all solutions to chronic pain. Doctors need to take the time to really get to know their patients and their condition so that they can help them find a treatment that works for them.

Don’t go for the quick short-term fix – Opioids can help mask the symptoms of chronic pain, but they won’t treat the underlying issue. As we’ve said on the blog countless times in the past, prescription medications can play a pivotal role in a comprehensive treatment plan, but they should not be the only form of treatment. Doctors should not rush to medicate without pursuing more active treatment methods.

Be ready to pivot – If one treatment isn’t working, it means that doctors need to be ready to pivot to another treatment. As we’ve mentioned, pain is highly individualized, so what works for one person isn’t guaranteed to work for another, and providers need to be flexible in their approach.

Continue to learn – Pain care is always evolving, and pain physicians need to keep furthering their understanding of chronic pain and how to best treat difficult cases. Doctors need to continue to seek out highly credible research in order to provide patients with the highest level of care.

Solving Chronic Pain On A Global Level

Solving chronic pain on a global level will take a more concentrated effort. Obviously there is no simple solution, but there are two main areas we should be focusing on. For starters, chronic pain prevalence needs to become more mainstream. Roughly one in five Americans deal with a chronic pain condition, so odds are a number of your family and friends are fighting an invisible fight each and every day, and many of them aren’t talking about it. We need to combat the stigma of chronic pain and find ways to talk about it so that more people are willing to take the necessary steps to treat their issue head on. Chronic pain patients shouldn’t have to live in the shadows, hiding their pain from those around them.

The other main way to work towards an effective solution to chronic pain is to increase funding for research. As we mentioned above, 50 million Americans battle a chronic pain condition on a regular basis, so there is clearly an audience ready to jump towards more effective treatments. We just need to find them, and the best way to do that is to invest in research programs dedicated to better understanding chronic pain.

If you want to speak to a pain management specialist who will work hard to accomplish those individual tasks and champion the idea of tackling chronic pain on a larger scale, trust your care to Dr. Cohn and his team. For more information or to set up an appointment, give his office a call today at (952) 738-4580.

Will I Ever Celebrate Independence From Chronic Pain?

June 29, 2022 / Thomas Cohn, MD

Independence Day is right around the corner, and the holiday got us thinking about the notion that everyone hopes to eventually become independent from their chronic pain condition. But how can we break free from our chronic pain condition and find that independence? In today’s blog, we share some some tips for becoming independent of your chronic pain condition.

Chronic pain conditions are highly unique to the individual, so there’s no one-size-fits-all path to break free from chronic pain. That said, many people who have been able to overcome their chronic pain condition have been able to do so by following some similar techniques. Here’s a look at some helpful ways to work towards independence from your chronic pain condition.

Be Active – We know it’s easier said than done to say “be active” when pain can make movement uncomfortable, but movement is crucial for your total body health. Activity gets your heart pumping, which pushes healthy blood throughout your body, ensuring that structures get the nutrients and oxygen they need to thrive. Exercise and activity has also been shown to release endorphins in the brain that can act as natural pain relievers.

Tweak Your Diet – There’s no magical diet that can cure your of your chronic pain, but if you are smart about what you put in your body, your diet can play a positive role in chronic pain relief. High fiber vegetables, fatty fish and vitamin-packed fruits can all help your body get the nutrients it needs to thrive. On the flip side, foods that are high in fat or carbohydrates can contribute to inflammation onset, which can make joint movement more uncomfortable. Strive to improve your diet or create a food journal so that you can get a better idea of what’s working and what’s not when it comes to your diet.

Work With A Specialist – Don’t try to overcome a chronic pain condition on your own, because it can be extremely daunting. Instead, connect with a specialist who can help develop an individualized treatment plan based on your specific needs. Knowing you have an ally in your corner can go a long way in helping your mental health, which is imperative for overcoming chronic pain, because pain conditions aren’t just a physical issue. Let a professional help guide you to independence from chronic pain.

Stay Hydrated – Your joints and muscles work optimally when they are appropriately hydrated, so drinking plenty of water throughout the day can help your body function and reduce instances of chronic pain. Being appropriately hydrated improves your circulation and makes it easier on your heart to effectively pump this blood throughout your body. Being hydrated won’t solve your chronic pain by itself, but it can make it easier for your muscles to move effectively during exercise.

We hope you have a wonderful 4th of July, and if you want help becoming independent from your chronic pain condition, consider syncing up with Dr. Cohn and his team. For more information, or for help with your chronic pain issue, give Dr. Cohn’s office a call today at (952) 738-4580.