I am a layperson, albeit a layperson who is living with intractable pain and have been for 27 yrs. This question is an interesting one for the community that lives daily in pain. One tha twe been asking for fa rtoo long. It is reassurring to find that there are physicians asking the same thing.

I see the questionn coming from an emotional point, granted. But the question was" what percentage..... understands what intractable pain is?" My guess is that not many do. And by the answers that floowed the question becomes lost in the polotics of chronic pain.

With all due respect, and admiration, for the question even being on the radar please let me say that unless a personhas (unfortunately) walked in a life with chronic pain, day after day, it is impossible to "understand". Even sharing with another person who lives with intractable pain is quite often an eye opener since of course no two people are alike.

The point of contention became here in this article, in this question just like it always does when the topic of chronic pain is the forefront of conversation or debate. It seems it always becomes about whether opiate treatment is appropriate,.. or not.
And if using opiate treatment,.. then the next bone of contention becomes addiction.
The questio, conversation or debate currently on the table then becomes sideswiped.

As a woman (56) who became one who has no choice but to live daily in pain when I was in my mid 30's I have come to know more than my share of medical treatment modalities.
In 27 yrs of using every one made available to me (that made sense) I am here to also confirm that I am not an addict, and that when there is a choice for me to live a non functioning life in pain that levels me fla; or a choice to use prescribed medication (opiates) and be a functioning member of my home, and of my community, I choose the latter. It's easy for me. It became about quality of life.
This is the one aspect of understaning intractable pain that I'd like to see absorbed.
Quality of life must come in to play somewhere, and matter a whole lot!

One more thing. If you take anything away from this discussion, let it be this.....

Pain should not be seen as a condition that is only subjectively rated, by patients on a scale from 1 to 10. That's just not true! Like any other disease, there are OBJECTIVE SIGNS OF PAIN! See Tennant, F. Pain Treatment Topics, 2008: http://pain-topics.org/pdf/Tennant-PainSigns.pdf

Thanks!

Re: Grace- Although you have mercifully dealing with IP for less years than I you have the wisdom of someone much older. Your mature style of writing and sharing about your own circumstances is amazing.
I am humbled by your honest intelligence and willingness to share. Like you I my treatment modalities area plenty. I thank God for them every day. I have had choices. I too rely on "living better through chemistry" and it took me a long time to accept that this is my life now. Acceptance is a hug for the IP patient by the way

My mind is buzzing with so much I'd like to say.
I have been advocating for myself and for others whose lives have been turned upside down by IP?CP for most of 20 yrs now. Those first years in pain were ones of isolation and self survival. Many aspects of chronic and intractable pain management have improved vastly. Others feel still are stuck in the dark ages. I started out being prescribed the typical doses of drugs like odd not typically prescribed anti-inflams, hydrocodone, muscle relaxers, tranqulizers, (the pain must be mentally induced), in the mid 80's and just as an an FYI I live in the pacific northwest. Then up the ladder to oxycodone. Along with even more and different anti-depressants, anti-inflammatory's, and even barbiturates. I had physical therapy, massage, ultra-sound, surgery,.... you name it, I had it prescribed, suggested, or I searched out. Anything for help to minimize the pain. I'd long given up of it ever going away.

I also did what I refer to as doctor shopping, all the time hoping and praying the next one had the answer for me. I worked in a mid size city pharmacy as a tech and I became some what knowledgeable about RX's, OTC's, homeopathic's, and supplement's. I was on the journey of my lifetime.
Including seeing naturopath's, osteopath's, physiologists,.... and all the pertinent specialist's.
I hated my what my life had become, I hated being associated with health issues of any kind let alone the stigma brought about by being in pain every day. Not to mention the attitudes of those in my inner circle who knew I was prescribed opiates.
Finally after about 10 yrs of this my husband was transferred to Seattle where I met my first internist who took me seriously. Together with a pain specialist, a pharmacists who specializes in pain management, and myself a plan was made. I was slowly weaned off the oxycodone that I was taking every 4 hrs to a drug whose name put the fear of God into me initially. Methadone. All I heard in my head was "this is a drug used for heroin addicts" What is going on? I am not an addict! Not now nor ever. As was explained and made so much sense the methadone was a "long acting" opiate and because my body would not be detoxifying it every 3.5 -4 hours my pain management could be better. So as not to get become an endorsement for this treatment for anyone else suffice it to say that for me, for my pain it was the answer I'd been searching for.
Gracefully my doctor sat down and educated me on it's use for intractable pain, the idea that my pain level could be managed was the first sign of hope in all those ten plus years.
Today thanks to new drugs like Lyrica and Savella I have been able to for the first time in 15 or more years to reduce my dose of methadone drastically. But I do "rely" on a small minimal dose every morning and sometimes during a months time may need to add an additional repeat dose in the evening to help sleep. This is only if I have a spike in my typical pain level that still lets me function and have a full life which for me is key.

I write about this only as a way of some back ground info to give myself some credibility on this site. After advocating online for close to 15 yrs I have discovered that everyone is not as transparent as they may seem.

With all this being shared I'd like to thank you to Grace for posing such a fascinating question and for inspiring such intelligent conversation. It would be quite amazing if we could build upon it. Yes?

And finally:
To the two doctors who joined in and shared so willingly and freely; may I just say how refreshing it is to find two professional medical providers willing to let their guard done with some with us lay people. To communicate with patients, not of your own who are trying to navigate through the medical community system of IP/CP with out a map is a gift.
Thank you for that!