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The way we were trained to think about pain isn’t correct

Recently, pain scientists have made important breakthroughs that can and should impact how we treat persistent pain. However, many physicians continue to operate on modalities that are 20–30 years out of date. It’s vital for us to address that.

In the video below, pain specialist and consultant Dr. Kevin Cuccaro summarizes the most recent pain science: redefining the concept of pain, the experience of which is extraordinarily individual. There are three components (the “pain triangle”) that determine how this experience plays out in a patient’s life.

By thinking about pain differently, we can treat it differently, empower patients to experience it differently, and achieve different (better) outcomes.

Opioids are not effective for persistent, non-cancer pain

Persistent, non-cancer pain is a real problem that your patients must deal with — yet while opioid prescriptions have become a common response, they’re not effective at treating this type of pain long-term, and they come with many risks.

Background information

Toward better outcomes

The Substance Abuse and Mental Health Services Administration (SAMHSA) has done a lot to advocate for better opioid prescription guidelines in the United States. They’re calling on healthcare providers to end the opioid epidemic by making changes to improve the lives of those living with persistent, non-cancer pain. Here at PainWise, one of our goals is to provide you with tools to do your part in this.

We encourage you to follow safe prescription guidelines, explore alternative treatments, and attend Continuing Medical Education (CME) events to stay current on the most effective techniques for treating persistent, non-cancer pain.


Tools and resources for clinicians

Oregon Pain Management Commission

The Oregon Pain Management Commission is a resource published by the Oregon Health Authority, providing resources, tools for pain care, guidance on medications and prescribing, and info on upcoming conferences and events — including options for free CME.

Safe prescription guidelines

In March 2016, the CDC released an updated national prescription guideline for prescribing opioids. It provides recommendations for primary care clinicians who are prescribing opioids for persistent pain outside of active cancer treatment, palliative care, and end-of-life care — addressing:

  • When to initiate or continue opioids for persistent pain
  • Opioid selection, dosage, duration, follow-up, and discontinuation
  • Risk assessment and ways to address the harms of opioid use

Oregon also released a set of Opioid Prescribing Guidelines for 2017-2018. For quick reference, see the U.S. Surgeon General’s Pocket Guide to Prescribing Opioids as well.

Overdose prevention toolkit (SAMHSA)

If you haven’t already, it’s worth reading the Opioid Overdose Prevention Toolkit in full.

Naloxone prescription guidelines

The routine prescription of naloxone to outpatients who may be at risk of opioid overdose and their family members is supported by the AMA, the ASAM, the AAPCC, the AACT, the ACMT, and the National Guideline Clearinghouse. See this naloxone prescription guide from MedStar Health for more information.

Prescription drug monitoring programs (PDMP)

Protect patient safety through your state’s Prescription Drug Monitoring Program (PDMP), which lets you verify your patients’ opioid prescription and pharmaceutical data.

According to the Substance Abuse and Mental Health Services Administration, PDMP programs are “a key strategy for addressing the misuse of prescription opioids and thus preventing opioid overdoses and deaths.” Through your state’s database, you can find out whether your patient is filling their prescriptions as planned, “or obtaining prescriptions for the same or similar drug from multiple prescribers.”

You can visit Oregon’s PDMP here.

Continuing Medical Education (CME) events

Free SAMHSA events. You can improve your ability to treat persistent, non-cancer pain by attending free educational events through SAMHSA. In the Opioid Overdose Prevention Toolkit, SAMHSA announced that federally funded CME courses are available to healthcare providers at no charge. Visit to explore courses available.

Local opportunities. Check with your local organization for other opportunities to continue your medical education. By staying current on effective techniques for treating persistent, non-cancer pain and dealing with opioid dependence, you could save a life.

Being PainWise. Explore the video presentations we’ve published on this website from our recent pain care conference, Being PainWise.


Techniques and resources for patients

How to talk with patients about pain

For patients who are dependent on opioids, motivational interviewing can make a big difference in the effectiveness of their therapy.

“Motivational Interviewing is a clinical approach that helps people with mental health and substance use disorders and other persistent conditions such as diabetes, cardiovascular conditions, and asthma make positive behavioral changes to support better health,” SAMHSA reported. “The approach upholds four principles — expressing empathy and avoiding arguing, developing discrepancy, rolling with resistance, and supporting self-efficacy (client’s belief s/he can successfully make a change).”

Many healthcare organizations are now combining motivational interviewing with other treatment options. To learn more, read the following articles:

Pain care classes in Oregon

Pain Solutions First Steps. This is a free, six-week series that helps patients with persistent pain develop tools to manage and treat their pain successfully. We’d like your help making sure patients have access to it. The classes are offered in Benton, Lincoln, and Linn counties. Space is limited, and registration is required; to register, patients may call (541) 768-6811 or email Find upcoming dates and locations at our classes & events calendar.

To request Pain Solutions First Steps brochures or flyers, contact the Samaritan Health Services Health Education Department at (541) 768-6811 or

Other classes and events. More information on other upcoming classes is available on our classes & events calendar.