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Chronic Pain In America: Roadblocks To Relief

Summary of Findings

Attitudes Toward Narcotic Pain Relievers

CHRONIC PAIN SUFFERERS CURRENTLY TAKING NARCOTIC PAIN RELIEVERS DIFFER FROM OTHER CHRONIC PAIN SUFFERERS AS TO THE SEVERITY OF THEIR PAIN, BEING LESS LIKELY TO HAVE IT UNDER CONTROL, CHANGING DOCTORS MORE OFTEN, REQUIRING MORE INTENSIVE TREATMENT AT HOSPITALS, TAKING MORE PILLS PER DAY, MORE LIKELY FOLLOWING THEIR DOCTOR PRESCRIBED REGIMEN AND LASTLY, TO BEING REFERRED TO A SPECIALIZED PROGRAM/CLINIC FOR THEIR PAIN.

Base: All chronic pain sufferers.

  ---Currently Taking---
  Narcotic Pain Reliever % Other Medicine Type %
Severity of pain (8,9 or 10) 56 31
Have constant pain 55 36
Pain pretty much under control 45 57
Currently going to doctor 88 60
Have changed doctors 57 45
In past 12 months:
Gone to emergency room for pain relief 27 12
Been hospitalized for their pain 19 10
Have had counseling 23 13
Total mean number of pills taken in typical day 5.7 4.4
Take as prescribed by their doctor 80 68
Referred to specialized program/clinic 36 19


ALTHOUGH THE GREAT MAJORITY OF CHRONIC PAIN SUFFERERS REACT POSITIVELY WHEN FIRST PRESCRIBED A NARCOTIC PAIN RELIEVER, THERE ARE CONCERNS RELATING TO SIDE EFFECTS AND BECOMING HABIT FORMING; HOWEVER, THERE IS RELATIVELY LITTLE CONCERN ABOUT WHAT OTHER PEOPLE THINK ABOUT THEIR USE.

"Which of the following statements describe your reaction when a narcotic pain reliever was first prescribed for your pain?" (Q. 11)

Base: All chronic pain sufferers ever taking narcotic pain relievers.

  ---Severity of Pain Now---
  Total % Currently Taking % Past User %
Optimistic and pleased that it would work 73 76 70
Would manage your pain successfully 72 76 69
Very concerned about its potential side effects 60 52 65
Concerned, went along since couldn't cope anymore with pain 55 57 53
Very concerned it would be addictive 49 43 52
Very concerned, would have to take it for the rest of your life 42 46 39
Very concerned it would require higher dosage over time 38 30 43
Felt you could manage pain without drugs 35 28 39
Didn't know it was a safe option 32 37 29
Surprised, didn't know it was an effective option 25 23 26
Very concerned, other people would view it negatively 20 24 17


THE MORE COMMON SIDE EFFECTS ATTRIBUTED TO NARCOTIC PAIN RELIEVERS ARE DROWSINESS AND DRY MOUTH ALONG WITH A RANGE OF STOMACH RELATED PROBLEMS; THE MOST BOTHERSOME ONES ARE THE ONES THAT OCCUR LESS FREQUENTLY SUCH AS VOMITING, URINARY PROBLEMS AND CONFUSION.

What side effects, if any, have you ever had that you believe were caused by the narcotic pain reliever you used for your pain versus a non-narcotic pain reliever?" (Q. 13a) "How bothersome was (SIDE EFFECT) you experienced? Was it very bothersome, somewhat bothersome or not bothersome at all?" (13b)

Base: All chronic pain sufferers ever taking narcotic pain relievers. Percent experiencing side effect. Percent saying symptom was very bothersome.

  ---Severity of Pain Now---
  Total % Currently Taking % Past User % Very Bothersome %
Had side effects 82 78 85  
Drowsiness 61 54 66 31
Dry mouth 51 46 54 24
Upset stomach 35 28 40 34
Nausea 31 27 33 36
Constipation 30 33 28 36
Confusion 21 17 24 40
Itching 17 18 17 36
Vomiting 11 10 11 61*
Urinary problem 10 11 10 47*

(* Caution small base)

THE MAJORITY OF CHRONIC PAIN SUFFERERS EVER USING NARCOTIC PAIN RELIEVERS NEVER HAD ANYONE EXPRESS A CONCERN ABOUT IT; AMONG THOSE WHO HEAR CONCERNS FROM OTHERS IT IS LIKELY TO BE A FAMILY MEMBER OR THEIR DOCTOR. THE CONCERNS EXPRESSED RELATE TO ADDICTION AND, ESPECIALLY AMONG FAMILY MEMBERS, SIDE EFFECTS.

"Have any of the following people ever expressed concern about your taking a narcotic pain reliever versus a non-narcotic pain reliever?" (Q. 12a) "What is your (PERSON'S) concern about narcotic pain relievers?" (Q. 12b)

Base: All chronic pain sufferers ever taking narcotic pain relievers. Percent identifying a person. Percent of other people stating a specific concern.

  Total % Currently Taking % Past User %
Other people expressed concern 44 47 41
Family member 27 31 25
Addiction 80  
Side effects 52  
Stigma 10  
No insurance coverage 10  
Doctor, specialist 24 24 23
Addiction 81  
Side effects 35  
Stigma 9  
No insurance coverage 6  
Friend 16 20 13
Addiction 85  
Side effects 36  
Stigma 9  
No insurance coverage 8  
Pharmacist 10 14 8
Managed care gatekeeper 5 8 4


FEW CHRONIC PAIN SUFFERERS BELIEVE DOCTORS HAVE EVER REFUSED TO PRESCRIBE A NARCOTIC PAIN RELIEVER TO THEM FOR FEAR OF BEING PERSONALLY CRITICIZED BY OTHERS.

"At any time has a doctor not prescribed a narcotic pain reliever for relief of your pain because the doctor was concerned that he/she would be criticized by others for prescribing that type of pain reliever?" (Q15e)

Base: All chronic pain sufferers.

  ---Severity of Pain Now---
  Total % Currently Taking % Past User %
Didn't prescribe, concerned about
being personally criticized		 5 13 4
Has not occurred 86 84 87
Don't know 8 2 10


THE QUALITY OF LIFE HAS IMPROVED SIGNIFICANTLY AMONG THOSE WHO HAVE THEIR PAIN UNDER CONTROL.

"For each of the following activities, please tell me whether you could do it all the time, some of the time or never?" (Q. 3d) "For each of the following activities, please tell me whether you could do it right now all the time, some of the time or never because of your pain?" (Q. 19)

  ---Pretty much under control---
  Before % After % Point Diff. # Not under Control %
Maintaining relationships with family/friends 58 77 +19 68
Concentrating 41 64 +23 51
Walking 37 50 +13 41
Doing full days work at job 34 43 +9 27
Caring for your children 30 35 +5 27
Participating in social activities 29 48 +19 33
Doing chores at home 29 50 +21 34
Doing usual hobbies/leisure activities 29 47 +18 31
Having sex 26 38 +12 27
Being in a good mood 26 45 +19 29
Sleeping 26 41 +15 20
Exercising 17 27 +10 17


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