PAIN MANAGEMENT: Baby Boomers, New Drugs Brace Field

      As a growing segment of the American population ages and new pain management drugs hit the market, "multidisciplinary clinics [are] cropping up all over the country and physicians [are] being encouraged to treat pain as the 'fifth vital sign.'" Saturday's New York Daily News devoted its entire Health & Fitness section to pain management. "It's an exploding field," said Dr. Carole Agin, director of the Pain Management Program at Montefiore Medical Center in the Bronx. "We don't have all the answers, but there are a lot more options today," she said. New drugs are offering patients greater hope than ever. The first COX-2 inhibitor, Celebrex, was released in February and a second, Vioxx, is expected to receive FDA approval this year. But doctors are looking to other approaches, such as physiotherapy, spinal-cord stimulators and epidural steroid injections (Gardner, 4/3).

Painfully Misunderstood
      Monday's San Francisco Chronicle ran a two-part series on pain management. The first, entitled "Affliction: Living with Chronic Pain," profiled several chronic pain sufferers and their "misunderstood, misdiagnosed and mistreated" chronic problems. Despite new drug delivery methods, the "medical system routinely fails those living, and dying, in pain," said Dr. Russell Portenoy, president of the American Pain Society. According to the Society of Neuroscience, chronic pain afflicts nearly 100 million Americans and exacts a $100 billion a year burden on society (Hall, 4/5). The second article, entitled "New Drugs Give Hope," focuses on "safer, more sophisticated treatment options for chronic sufferers," such as the COX-2 inhibitors and Immunex Corp's recently approved Enbrel for rheumatoid arthritis (Hall, 4/5).

Pain Centers
      Pain management centers are popping up throughout North Carolina, where "managing chronic pain has become big business," the Greater Triad Area Business Journal reports. The American Academy of Pain Management reports that 3,000 such facilities have cropped up nationwide, with 24 in North Carolina. The Business Journal attributes the exploding market to patients' increased awareness of available therapies and anesthesiologists' eagerness to "add to their income by moving into pain management." But Dr. Richard Weiner, director of the American Academy of Pain Management, said that even as the demand for pain control grows, insurance reimbursements will decrease considerably (Stiff, 4/5 issue).