Are patients kept in the dark?

A study was recently done using information from the Integrated Healthcare Information Services National Managed Care Benchmark Database (phew!  We’ll just call it IHCIS) to find out how migraine treatment was going.  This is a study from the USA based on actual health insurance claims from over 6 million patients.

It’s believed that about 10-15% of the population in the USA suffers from migraine.  However, only about 3% of the people in the survey were actually diagnosed with migraine.  So either the first number is waaay off, or the other 10% get very minor attacks and don’t feel they need a doctor, or else many many many people just aren’t getting the treatment they need.

The other news (not exactly a surprise, mind you) is that only about half the patients with migraine got typical headache medication.  In fact, only about 20% got the targeted migraine drugs known as triptans.  In contrast, well over half of those given headache medication were given narcotics and opioid analgesics, such as medications with codeine and morphine.

Now don’t get me wrong – narcotics have been a huge help to many, many chronic pain patients.  That includes migraineurs.  However, certain things about these numbers should cause concern:

  • First, now that the more migraine-specific triptan drugs have been available for well over a decade, why aren’t doctors prescribing them more often?
  • Narcotics have helped many migraineurs, but they are not the first line of attack for someone suffering from regular attacks.  Because of the dangers of rebound headache and dependence in general, they’re more toward the last-resort end of the drug scale.  And yet, in spite of all the better options available, they’re still being prescribed over half the time (in the headache drug category) for migraine.
  • Again, it still looks like many people aren’t even getting a proper diagnosis.  Migraine should not be ignored – there is help available.
  • True, many people are not helped by triptans (though if they’ve only tried one, they should try other types).  Narcotics may be the only thing that works.  I emphasize this because some seem to think that most people with chronic pain are just out for the drug high.  That’s not the case – most people I’ve heard from are simply looking for solutions.  And these numbers suggest that people are not being made aware of the solutions that are out there.

    If triptans, other migraine drugs or the many good preventative options don’t work for you, you may need to take more drastic measures.  But most people need to try the best options before they get that far down the road.

    Ok, I’m done my rant.  For more on the study, read the press release New Analysis Shows High Narcotic Use Among Headache Sufferers.

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