Top Menu

In Era of Prescription Drug Abuse, Doctors Have Few Tools to Measure Pain


In an era when prescription drug abuse is on the rise, doctors still don’t have a good way to measure pain objectively, The Wall Street Journal reports. The most common way to measure pain is to ask patients to rate it themselves on a scale of one to 10, or to match up their pain to a cartoon face that shows an expression similar to what they are feeling.

Joel Saper, Director of the Michigan Head Pain and Neurological Institute in Ann Arbor, told the newspaper, “We don’t have a pain-o-meter.” His estimate is that between 15 to 20 percent of patients seeking relief from pain either don’t have pain or have less pain than they say they do. There are a variety of reasons why patients fake pain. While some are dependent on opioids or want to resell them, others want to get out of working and collect disability. Still others find power in their pain, Dr. Saper says.

Even among patients with real pain, level of tolerance for pain varies widely. Doctors must balance the abuse of prescription painkillers with the real need of patients in pain, the article notes. An estimated 116 million Americans suffer from chronic pain. Low back pain is the most common type of pain, affecting 28 percent of the population. Knee pain is second, affecting 20 percent, according to a new report by the Institute of Medicine called Relieving Pain in America.

Some doctors ask patients who they feel are at risk of prescription drug abuse to sign an opioid contract. This agreement establishes an understanding that the patient will only receive opioids from that doctor and only one pharmacy. The patient may be asked to submit to urine drug screening, and is told that if their medication is lost, it will not be replaced. Stolen medication will only be replaced if the person brings a police report.

Many states also have prescription drug databases that doctors can check to find out whether patients are receiving similar drugs from other doctors in the state.

8 Responses to this article

  1. Avatar of ben Lippolis
    ben Lippolis / July 19, 2011 at 11:29 am

    People need to understand pain better instead of hiding it, to feel pain is to know you are alive, we need to stop treating everyone like little babies and deal with it, pain killers are people killers and our doctors are doing the opposit from from what they went to school for they use to want to heal us now they are trying to kill us, what is wrong with them. O ya its all about the money. We need to make it to were the doctors are not making so much money from the pharmisudicle companies and doctors are not making so much money cause that is what it is all about. Doctors should not get a prophit from killing people, they should be trying to help. I want to help not sure how but i can not sit by and watch this happen. Please i am looking for some kind of orginization that I can be appart of to help. My email is

  2. Eva / July 8, 2011 at 6:10 pm

    I was treated by a chiropractor decades ago for back pain stemming from an accident. He had a “pain-o-meter”. He used a tool that he would pass over the area and would spike when it hit the worse areas. I think he said it measured heat as an indicator. Why can’t doctors use something like that to weed out some of the drug seeking patients. I have gotten to the degenerative disc stage and suffer some pretty intense sciatica. My doctor has allowed me to take methadone which has kept me in the ranks of the employed. It is long acting and effective for chronic severe pain. I think this is much better than having the up and down relief of codeine or vicodin or others. I think the doctors who prescribe have the right to test for other drugs but I don’t like the idea of being in a “drug treatment” setting like a clinic for this medical condition. It’s all about ethics i guess.

  3. Eric Wood / July 7, 2011 at 5:52 pm

    Pain happens for a reason. It is a signal to the brain that some area of the body is damaged and in need of healing. Simply blocking the brain’s experience of pain takes needed attention away from the injured area, allowing for further injury. Why has the Western approach to medical practice devolved into treating the symptom more than trying to solve the underlying problem? Sure, we already know the answer to that question.

  4. Avatar of Melissa
    Melissa / July 6, 2011 at 4:32 pm

    In one of the above comments, I think 80% is quite high on the need of opiates. The state in which I live there is a nice little thing called the BOP (Board of Pharmacy). Any practicing physician can obtain fairly updated records on scheduled drugs, on any patient with a name and DOB. All they need to do is sign up with their information and DEA# and can get this information online instantly. I think all states should be doing this. It is truly a great instrument for discerning dr. shoppers and drug seekers from legit. patients.

  5. Rebebecca Doane / July 6, 2011 at 2:11 pm

    They are doctors and they should have medical data to rely on, such as MRIs, cat scans and numerous other tools. I dont believe for one minute they cant know most if these people are addicts. Its about the money because they are making fortunes on these people, our governmemt, and insurance compaines! I was borned in the 50s.and my mom had Hogdins disease and she only took Bayer aspirin! People with a fatal disease do need the meds for pain, but everyone else needs to seek alternative treatment before they become addicts. Trust me I have been there. I had the medical records, and could get anything I wanted until I realized the pain pills were killing my body and my mind! I went to acpuncture dr.and was pain free in 6 weeks. Then when I stopped taking the drugs was when I realized I had made a terrible mistake. For six months, I went thur pure hell! I tried to do detox on my own and was a big mistake. If you or one of your loved ones are taking pills for pain, please try and find alternative terms for treatment!

  6. Dave / July 6, 2011 at 2:09 pm

    Pain is inherently subjective. So to even talk about objective pain measurement is an oxymoron. We’ve had this discussion before and the upshpt was to medicate reported pain if it increased functionality. What’s wrong with that solution?
    Yes, some people manipulate the system for gain of because of addiction but why should the other 80% suffer pain that could be medicated because of that?
    Seems like the solution is to have everyone do the contract (not just a select few) and then monitor compliance and whether functionality is improving.
    If there’s a problem with either, then it’s time to consider other solutions (substance abuse treatment, psychotherapy, pain management clinics, legal consequences, etc.)

  7. joebanana / July 6, 2011 at 1:23 pm

    In an era of television, magazine, billboard, subliminal, bus bench, and radio advertising for prescription drugs, people now go to their doctors with shopping lists, even if they’re not sick. How wonderful for these snake oil peddlers.

  8. Avatar of David H. Kerr
    David H. Kerr / July 6, 2011 at 1:18 pm

    In some cases, there are exercises for the patient to do on a daily basis that will strengthens muscles to ameliorate pain. Doctors should approach the pain medicine remedies with a long term approach that requires some long term responses by the patients. We have seen thousands of years of recorded history with NO PAINKILLERS. Let’s look back and see how our grandparents handled pain. If we look, we may find many healthy activities that can lessen pain and we can also try to decrease those that cause pain.

Leave a Reply

Please read our comment policy and guidelines before you submit a comment. Your email address will not be published. Thank you for visiting

− one = 7

Reproduction in whole or in part of this publication is strictly prohibited without prior consent. Photographic rights remain the property of Join Together and the Partnership for Drug-Free Kids. For reproduction inquiries, please e-mail