A report, issued by the Centers for Disease Control and Prevention and the National Health Interview Survey, stated that 20.4% of adults in the United States in 2016 had chronic pain lasting longer than three months. In 2023, that figure rose to 24.3%.

“What is clear is we have an astounding and growing public health crisis of chronic pain,” said Stanford School of Medicine’s Dr. Sean Mackey in an article published by MedPage Today, an investigative reporting site for health care professionals. Mackey also co-authored the CDC’s analysis. “This crisis touches everyone and requires a broader public health approach to reverse this concerning trend.”

Although the reason for the increase isn’t completely clear, experts do have some theories. They include the growing population of older adults, who can suffer with chronic pain as they age. The COVID-19 pandemic may have also played a role, Mackey said.

“The pandemic led to delays in health care access and surgeries, increased sedentary lifestyles and heightened mental health challenges such as anxiety and depression, all of which are associated with chronic pain,” he said. “Even outside COVID, we appear to have a more highly stressed population.”

Diabetes, obesity and several chronic diseases also are thought to play a role, he said.

Another reason could include the changes in opioid management and limitations on dosages by the CDC in 2016 for patients with long-lasting chronic noncancer pain. The guidelines included Morphine Milligram Equivalent Daily Dose (MMED), which represents converting every opioid to an equivalent of morphine.

In 2022, the guidelines were revised, adding more flexibility, but several health care workers said it was still challenging to prescribe medications. Mackey said efforts to reduce opioid prescriptions may have led to inadequate pain management in some people.

“We have been concerned about this unintended consequence for a long time,” he said. “We will continue to see higher rates of chronic pain in our population unless we change how we deliver optimal care to all people.”

In an email to MedPage Today, Dr. Charles Argoff, who is president of the American Academy of Pain Medicine, and President-elect Dr. Antje Barreveld said those with the greatest need for chronic pain care too often do not have access to the type of pain management care that is most likely to help.

“We will continue to see higher rates of chronic pain in our population unless we change how we deliver optimal care to all people. A fear of opioids and misconceptions about what else besides medications can help reduce pain also has led to many health care providers being afraid to treat chronic pain,” the email said.

Cindie Dodenbier, a nurse practitioner specializing in pain management across the state, said the issue is critically important.

“In the 30 years of my experience, not one of my patients has died,” Dodenbier said. “Everything I’m doing coordinates with chronic pain guidelines, which includes a physical exam and comprehensive three-hour intake. I also have a mental health expert on board which is very important when treating chronic pain.”

Dodenbier said there are countless numbers of patients who suffer from chronic pain and can’t function normally without pain-controlling medications. She said many people are terrified to even ask for an opioid prescription out of fear of being labeled an addict.

“One in 10 people are born an addict, and that’s to anything. Some people crave alcohol while others crave sex or shopping. That rings true for drugs as well and the fact of the matter is that most people who are dying aren’t these patients who are taking their medicine responsibly.”

According to Utah.gov, drug overdose is the leading cause of injury death in Utah, outpacing deaths due to falls, vehicle accidents and firearms.

“Ten Utahns die each week from drug overdose. Utah is particularly affected by illicit opioids, specifically fentanyl, which is responsible for 33% of the unintentional and undetermined drug poisonings in the state,” according to the state data.

Additionally, deaths involving illicitly manufactured synthetic opioids, including fentanyl and stimulants, were responsible for a majority of drug overdose deaths from 1999-2023, according to the U.S. Department of Health and Human Services. People without health insurance or who were incarcerated or living in poverty were at an increased risk of fatal opioid overdose.

The department noted that synthetic opioid deaths, excluding methadone, increased 103-fold during that time period. Methamphetamine (psychostimulants) increased 64-fold, cocaine deaths increased 7.6-fold, heroin deaths more than doubled and prescription opioid overdose deaths quadrupled.

Dodenier and Red Lawhern, a national chronic pain advocate, research analyst and health care writer, both said that a majority of the problem stems from people taking cocaine, heroin or fentanyl mixed with other drugs and alcohol.

Lawhern stated that overdose mortality is dominated by “self-administered poly-pharmacy involving alcohol and street drugs,” and said even when an opioid is found, it is only rarely traceable to a state prescription drug monitoring program and almost never the only contributing cause of death. Accidental drug mortality is now dominated by illicit fentanyl, often mixed with stimulants, he said.

“My patients don’t mess with their lifeline,” Dodenbier said. “And I test them randomly.”

The CDC reports 8.5% of U.S. adults suffer from chronic pain severe enough to restrict their daily activities.

“The denial of prescription analgesic medication to chronic pain patients has caused unnecessary suffering,” Lawhern said in a blog post. “But it has also driven up the suicide rate, trapping those who cannot bear to live without the drugs that have kept them functioning for years.”

Dodenbier said many people with chronic pain are sick to begin with and by the time they see her, they have exhausted nearly every form of treatment to help their pain.

“Chronic pain management is palliative care,” she said. “They just don’t have a death date. Most people, by the time they reach my office, have exhausted every other interventional treatment. Imagine if this is you or someone you love caught in this horrific situation.”

Dodenbier said the most important thing the public can do is educate themselves about chronic pain and their rights to treatment and to have compassion on those around them who are suffering.

“Do some personal investment into what these people go through. Have regard for your neighbor who has the misfortune of having chronic pain and don’t just write them off as a drug addict” she said. “There’s so much misinformation out there, but there are states writing laws to protect the rights of chronic pain patients. Utah isn’t one of them. That needs to change.”