Interview with Dr. Steven Passik – Question #4

Question #4: Can you envision a cultural transformation as called for by the Institute of Medicine?

Dr. Lynn Webster [Dr. Webster]: Hello, this is Dr. Lynn Webster. Thank you for listening to the Pain Topics series of interviews on Today I am back with Dr. Steve Passik to continue our discussion. Dr. Passik is a clinical psychologist and vice president of clinical research and advocacy at Millennium Health. Thank you for joining me, Dr. Passik. Today, I’d like to ask if you can envision a cultural transformation as called for by the Institute of Medicine?

Dr. Steve Passik [Dr. Passik]: Yeah, you know I’m a pretty optimistic person.  I’m not loving what I’m seeing going on in the world right now around these issues but you know what, I’m started to see some cracks already.  I think even the – there’s a little bit of an acknowledgment that all the uproar about opioids and prescription opioid abuse in particular has died down, it seems to me, a little bit and I think there’s a little bit of a somber realization that there’s no reason to feel a whole lot more virtuous if there’s all kinds of people are dying of heroin overdoses as opposed to the ones that doctors prescribed.  And I think they’re realizing that, “Whoa, substance abuse is a massive problem and it didn’t go away just because we did this.” And now, there’s going to be some indications that the kinds of steps that have been taken have actually made life worse for some people too, namely the illegitimate – the people that needs access to opioids for pain.  And so, I think it’s a pendulum and I think the pendulum swings back and forth.  Now, cultural transformation would mean that the next time we see a little bit more fair attitude is not solely a pendulum swing that’s about to go back that we really do change in a way in which we look at all of this. And I could envision it because we’re an aging population, we’re an increasingly obese population, in other words a set up for more and more us having pain, more and more of us knowing people in pain just like you said in the intro to your book that I thought was great.  And I think it might ultimately be driven by the patients themselves, that they’ll get more activated and begin to push for it because I don’t see the medical profession being able to, in any way, shape or form, turn their back on people with chronic pain.  It’s too many of them and it’s too common to complain.  And what I’ve always found maybe a little hardening in all this, at least where opioids are concerned, is that with all the uproar and with all the grief that has come to doctors around opioids and all the problems, and I don’t just mean grief from the patients, I mean grief from the regulatory climate souring and all that, you don’t really see the prescribing numbers falling off like to a massive extent that they’re still in there plugging away because they are still devoted to their patients and their patients still need them to be.  And you don’t really see the prescribing numbers completely disappearing as some might have predicted, I think, and I think that’s because, and implicit in that, is the fact that there’s a lot of pain and a lot of demands that people to take notice of it and treat it.

Dr. Webster: I hope we are beginning to see some cracks that can lead to a better future for people in pain. Thank you for participating in today’s interview, Dr. Passik, and thank you to the listeners for tuning in to Pain Topics on Please come back tomorrow for another question with Dr. Passik. If you aren’t already, please follow me on Twitter @LynnRWebsterMD. Also, stay tuned to my blog for more information about my upcoming book and documentary, titled The Painful Truth, to be released this fall. Thank you and have a great day.

Steven D. Passik, Ph.D.
Vice President of Clinical Research and Advocacy, Millennium Health

Steven D. Passik, PhD, is vice president of clinical research and advocacy at Millennium Health. Before coming to Millennium, Dr. Passik was professor of psychiatry and anesthesiology at Vanderbilt University Medical Center in Nashville, Tenn. He was section co-editor for the opioid pain and addiction section of Pain Medicine, served on the editorial board of the Journal of Pain and Symptom Management and has been a reviewer for many peer reviewed journals, including The Clinical Journal of Pain. Dr. Passik was editor in chief of the National Cancer Institute’s PDQ Supportive Care Editorial Board. He was named a fellow of Division 28 of the American Psychological Association (Psychopharmacology & Substance Abuse) and awarded a Mayday Fund Fellowship in Pain and Society. An author of more than 200 journal articles, 60 book chapters, and 59 abstracts, he speaks nationally and internationally on pain, addiction and the pain/addiction interface. Dr. Passik received his doctorate in clinical psychology from the New School for Social Research, New York, and was a chief fellow, Psychiatry Service at Memorial Sloan-Kettering Cancer Center in New York.

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