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Guidelines and Policies: Implications for Individual and Population Health
David T O'Gurek1, Menachem J Leasy1
1Department of Family and Community Medicine, Lewis Katz School of Medicine at Temple University, 1316 West Ontario Street, Philadelphia, PA 19140, USA.
Primary Care
|September 24, 2022
Summary
The opioid crisis, driven by rising prescription rates, led to policies that worsened chronic pain management and highlighted systemic inequities. Future strategies must address root causes and use trauma-informed care.
Area of Science:
- Public Health
- Pain Management
- Health Policy
Background:
- Rising prescription opioid rates for chronic pain since the 1990s fueled an overdose crisis.
- Public health strategies and guidelines, though theoretically grounded, were based on limited evidence.
- This led to discordant policies, controversies in pain management, and negative patient experiences.
Purpose of the Study:
- To analyze the impact of public health strategies on prescription opioid use and chronic pain management.
- To examine how guideline development and policy implementation affected patients with chronic pain.
- To highlight systemic inequities and racism within the healthcare system related to pain management.
Main Methods:
- Review of public health strategies and guideline development related to prescription opioids.
- Analysis of the consequences of these strategies on chronic pain treatment.
- Examination of the role of systemic racism and inequities in pain management.
Main Results:
- Policies derived from limited evidence created rigid and discordant approaches to pain management.
- The treatment experience for individuals with chronic pain was negatively impacted.
- Existing systemic inequities and racism were exacerbated within the healthcare system.
Conclusions:
- Current public health approaches to the opioid crisis require re-evaluation.
- New strategies must be holistic, addressing root causes and inequities.
- Adoption of trauma-informed principles is crucial for effective and equitable pain management.
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