The use of opiod medication, a subject rife with controversy, took center stage when the Pain and Palliative Care Group (PPCG), an OU-COM organization open to any Southeastern Ohio health care provider who has an interest in complex pain management issues, held its second annual seminar.    

Held in September as part of Ohio’s Pain Awareness Month, the seminar addressed such topics as pain pathways, the relationship between health care providers and the criminal justice system, and the roll-out of new clinical tool—the Rational Opioid Use Tool—that guides clinicians through the process of assessing and scoring pain to help determine treatment decisions.

“We’re really just looking at increasing practitioners’ comfort in prescribing medication for non-malignant pain,” says Tracy Marx, D.O., assistant professor of family medicine and associate chair of the Department of Family Medicine, who along with Sarah McGrew, B.S.N., adjunct faculty instructor in the Department of Social Medicine, organized the seminar.

“It’s so important to individually assess patients,” McGrew adds. “This tool is an effective and cost efficient method that allows clinicians to make an informed decision about the use of opioids when treating patients with chronic pain.”

Another tool available to physicians is Ohio’s Automated Prescription Monitoring Program, “a godsend for practitioners,” Marx notes. The program allows doctors to view their patients’ prescription records and search for possible medication abuse.

But prescription pain medications aren’t the only answer for chronic pain. McGrew and Marx champion physical activity to combat a vicious cycle of disease, resultant loss of function, fatigue and emotions like anxiety, frustration, guilt and depression.

“It’s counterintuitive. Most people don’t realize that exercise helps pain,” says McGrew, who lectures osteopathic medical students on non-drug pain management techniques. These include osteopathic manipulation, massage therapy, physical therapy, heat and cold treatment, acupuncture, biofeedback and other complementary alternatives to prescription pain medications. She also arranges for arthritis patients to share their experiences with fi rst-year students.

“Pain affects everyone regardless of socioeconomic status, educational level, and disease,” Marx says. “It doesn’t fit nicely into a specialty, so it’s something that falls through the cracks a lot.”

When Marx was a medical student at OU-COM, information about addiction, pain or palliative care wasn’t part of the curriculum. She says the addition of these to the curriculum, which is taught during an intensive two-week session, ranks OU-COM among the top medical schools in Ohio for pain management education.