Those of us who treat people living with pain have always known that educating the public, as well as the medical profession, is critical. Ignorance about persistent pain as a disease is a major roadblock for its victims. A misinformed public is less likely to provide the financial and professional resources needed to combat the serious public health issue of pain.

There is overwhelming evidence about the scope of the problem of pain and the ability of pain medicine physicians to offer effective treatment. Unfortunately, that evidence largely lies buried in scientific journals. Attempts by pain specialty organizations to publicize the plight of pain patients and the advances made in treatment have fallen — for the most part — on the deaf ears of the press. While there are occasional "feel good" articles about successful treatment, these often seem to be connected to victims who are well known (eg, Jerry Lewis' battle with pain and his use of a spinal cord stimulator). And why not? That's "good press" and sells newspapers. Who wants to read about "Average Joe" from "small town America" with the same problem?

A disturbing trend in the press in covering medical topics is the tendency to focus on controversy and/or the negative. Glaring examples are the many articles about narcotic abuse and criminal diversion. Overlooked and underreported is the fact that this class of drugs, when used properly and under medical supervision, has kept millions of Americans more functional in the face of pain-producing illnesses and accidents. Once again, focus on controversy and negativity "sells" better than "feel good" stories.

One of the most glaring examples of biased reporting appeared in the New York Times on January 14, 2008, in the article, "Drug Approved. Is Disease Real?" by Alex Berenson. Mr. Berenson reported the story about the US Food and Drug Administration's (FDA) approval of the drug Lyrica for treating fibromyalgia by shamelessly emphasizing the many millions of dollars the pharmaceutical company, Pfizer, will make for a drug Mr. Berenson claims "will probably do little for patients." The article also emphasizes that some doctors believe fibromyalgia "does not exist and that Lyrica and the other drugs will be taken by millions of people who do not need them."

Where did Mr. Berenson get his information? Although presented as a balanced story, the focus clearly was on the remarks of a few well-known medical skeptics who questioned not only the existence of the medical disorder called fibromyalgia, but the integrity of patients who have it, physicians who treat it, and Pfizer, which spent millions of dollars in developing the drug. Below are two quotes to illustrate the point:

1. "These people live under a cloud and the more they seem to be around the medical establishment, the sicker they get." (Dr. Norton Hadler, University of North Carolina).
    
2. "People with fibromyalgia do not adapt." (Dr. George Ehrlich, University of Pennsylvania).

Overlooked by Mr. Berenson was the fact that the FDA approved Lyrica for the treatment of fibromyalgia after reviewing Pfizer's extensive clinical studies and determining the potential benefits of the drug for patients with fibromyalgia outweigh the potential side effects. Mr. Berenson goes so far as to imply that this approval was some sort of political decision on the part of the FDA when he states that "senior FDA officials overruled the initial reviewers." He also ignores the fact that the National Institutes of Health recognizes the condition as a medical diagnosis and funds research related to fibromyalgia and that most physicians practicing pain medicine recognize fibromyalgia as a syndrome requiring treatment.

If the public is to be properly informed about health issues and advances in medicine, it is incumbent upon the press to present that information in an unbiased way rather than sensationalizing stories. Nowhere is the right to know the truth more sacred than in the arena of public health. Misinformation in medical reporting ultimately may be harmful to one's health.

Richard L. Stieg, MD, MHS
Editor-in-Chief, www.NationalPainFoundation.org
Past President, American Academy of Pain Medicine

Following is a link to the article by Mr. Berenson in its entirety and this author's letter to the editor of the New York Times in response to this article.

Drug Approval. Is Disease Real? By Alex Berenson

Letter to the Editor:

Your biased article "Drug approved. Is disease real?" is harmful to millions of fibromyalgia (FMS) victims. While there was some appropriate commentary, you added the views of well known skeptics who do not represent Pain Medicine in the U.S.

The fact that there are "nebulous" (poorly understood) conditions like FMS makes them no less real to the sufferer. Dr. Ehrlich's statement that "people with fibromyalgia do not adapt" is pejorative and does injustice to the many FMS patients who do their best to cope and to the doctors that treat them.

FMS is a syndrome, not a disease. If the FDA saw fit to approve Lyrica for FMS treatment after reviewing Pfizer's clinical studies who is Mr. Berenson to marginalize the victims, their physicians or the company which likely spent millions in bringing this breakthrough drug to market?

Richard L. Stieg, M.D.
Past President, American Academy of Pain Medicine
Editor-in-Chief, www.NationalPainFoundation.org