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Dr. David Agnew Sees Pain as Pathway to Abuse But Cautions Against Overreaction

Fellowship Story Showcase

Dr. David Agnew Sees Pain as Pathway to Abuse But Cautions Against Overreaction

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This article was written by Noozhawk Intern Tim Fucci as part of Day 9 in Noozhawk's 12-day, six-week special investigative series. Related links are below.

The Noozhawk's Prescription for Abuse series is a special project exploring the misuse and abuse of prescription medications in Santa Barbara County. Our series is a result of an exciting and unique partnership with USC's Annenberg School for Communication & Journalism, which awarded Noozhawk a California Endowment Health Journalism Fellowship to undertake this important work.

Through our reporting and presentation, we will establish an independent baseline of where our community is with respect to the misuse and abuse of prescription medications; how the problem is affecting health care, education, law enforcement, criminal justice, addiction and treatment, and our culture and society; what we as a community can do to educate ourselves about prevention and controls; and how we can perhaps reverse what appears to be a very troubling trend.

Noozhawk staff writers Lara Cooper and Giana Magnoli are the lead reporters on the project, and they've been assisted by managing editor Michelle Nelson; reporters Alex Kacik and Sonia Fernandez; interns Kristin Crosier, Jessica Ferguson, Tim Fucci, Kristen Gowdy, Jessica Haro, Daniel Langhorne, Alexa Shapiro, Sam Skopp, Erin Stone and Sarah Webb; photographers Garrett Geyer and Nick St.Oegger; content producer Cliff Redding; and Web development staffers Will Macfadyen and Edgar Oliveira.

Ashley Almada, Garrett Geyer, Hailey Sestak and Billy Spencer of the Santa Barbara Teen News Network filmed more than two dozen public-service videos featuring many of our story sources.

The project is sponsored by the Santa Barbara Foundation in partnership with KEYT, sbTNN and Zona Seca. The Annenberg School is assisted by the Renaissance Journalism Center at San Francisco State University.


Day One:

» Quiet Epidemic of Prescription Drug Abuse Taking a Toll on Santa Barbara County

» After Losing It All, Former Drug Addict Looking Forward to Renewed Life

» USC, California Endowment Unite to Support Health Journalism at the Source

» Bill Macfadyen: Prescription for Abuse Project Is a Series of Opportunities

Day Two:

» Local, National Statistics Reveal Alarming Jumps in Misuse and Abuse of Medications

» Marijuana Use Trends Higher, Especially Among Young Adults, Sparking Public Health Concerns

» Alcohol Plays a Role All Its Own in Setting the Stage for Local Abuse, Overdoses

Day Three:

» Understanding Addiction Key to Dealing With Prescription Drug Abuse

» Donna Genera Has Seen the Price and Perils of Drug Addiction from All Sides

» Rich Detty Bears Burden of Not Knowing Extent of Dead Son's Drug Use

Day Four:

» Escalation of Drug Overdose Deaths Includes Increased Presence of Prescription Medications

» Santa Barbara Teen News Network Adds Another Dimension to Prescription Drug Abuse Series

» Dr. Chris Lambert Sounds Warning on Mixing Prescription Drugs with Alcohol

Day Five:

» Local Oversight of Prescription Medications Is Far More Focused Than State, Federal Controls

» Elderly Are Particularly Vulnerable to Both Misuse and Abuse of Prescription Drugs

» Second-Generation Pharmacist Peter Caldwell Fills a Vital Role with Patient Health Care

Day Six:

» Early Education for Parents and Youth Emerges as Critical Tactic to Thwart Drug Use

» Student Highs Can Lead to Tragic Woes with Addiction's Hook Just One Fateful Step Away

» From an Early Age, Shereen Khatapoush Saw the Horrors of Substance Abuse

» As a Parent Herself, Prosecutor Von Nguyen Brings Empathy to Job in Juvenile Justice

Day Seven:

» Law Enforcement Fights Battle Against Prescription Drug Abuse from Outside and Inside

» Sheriff Bill Brown a Strong Supporter of Re-Entry, Drug Abuse Treatment Efforts

» Speaking from Experience, Zona Seca's Kevin Smith Keeps Drug Abusers on Road to Recovery

Day Eight:

» Prescription Drug System Is Rife with Loopholes, Fraud and Lack of Oversight

» For Clinical Psychologist Neil Rocklin, Addiction Education Can't Begin Soon Enough

Day Nine:

» Drug Abuse Treatment Programs, Expertise Are Plentiful on South Coast

» Dr. David Agnew Sees Pain as Pathway to Abuse But Cautions Against Overreaction

Day Ten:

» Awareness, Disposal Key Elements to Reversing Tide of Prescription Drug Abuse

» Dr. Joe Blum Keeps Focus on His Veteran Patients Despite Health-Care System's Restraints

Day Eleven:

» Operation Medicine Cabinet Gets the Drop on Prescription Drug Disposal

» Lacey Johnson Gives UCSB Students an Education in Dealing with Drug Abuse and Addiction

Day Twelve:

» Santa Barbara County Officials Look for Solutions in Battle Against Prescription Drug Abuse

» Noozhawk Journalists Recount Lessons Learned from Prescription Drug Abuse Series

» Annenberg Fellowships Take a Diverse Approach to Community Health Journalism

» Dr. Nancy Leffert Champions Antioch University's Role in Fight Against Substance Abuse

» Professionals Working in Addiction Field Often Share Roots at Antioch University Santa Barbara

Neurologist and pain medicine specialist says bigger risk is patients' prescriptions falling into the wrong hands
Sunday, October 9, 2011

Name: Dr. David Agnew

Location: Santa Barbara

Role: Pain doctor

Pain is by no means a simple issue. As such, addressing and properly diagnosing pain can be a highly intricate and complex process involving the specialties of several trained professionals.

Dr. David Agnew, a Santa Barbara neurologist and pain medicine specialist, has been working for nearly 40 years to demystify and elucidate the complicated practice of treating human pain.

Agnew, who attended the University of Pittsburgh School of Medicine and completed his pain fellowship at the Institute of Neurology in London, said he first became interested in treating pain while attending a lecture by Dr. Howard Fields at UCSF School of Medicine.

“It was a field that there was little known about,” Agnew told Noozhawk. “There’s really no way to evaluate the level of pain someone has. You can only rely on what the patient tells you. You then have to evaluate with scans and X-rays, and see if it all makes sense.

“Pain involves many different aspects of someone’s history, experiences and daily lifestyles, and this contributes to what we’re feeling today.”

A member of the clinical faculty of the USC Keck School of Medicine’s Department of Neurology, a founder and fellow of the American Academy of Pain Medicine and an early member of the American Pain Society, Agnew is the one of the country’s leading practitioners in pain medicine. He has treated some of the field’s most severe cases.

“Usually I see people with the more difficult pain problems,” Agnew said. “Fibromyalgia, a collection of syndromes but not knowing the cause, I work with often. Sometimes it can be even more complicated, but if you take the time to sort out the causes of the pain, then you can help them.”

There is no set protocol to treating pain, according to Agnew. Acupuncture, massage, tai chi and a combination of other therapies have benefited some patients immensely, he said. A common element found in most treatment plans, however, is prescription medication and narcotics.

“I frequently prescribe medication to my patients, but only if it allows them to recover,” Agnew said. “All too often doctors and patients want a quick fix, and they are prone to getting a quick fix when it’s not the best option.”

Asked his level of concern for the potential of one of his patients abusing a prescription, Agnew said it wasn’t his patients he was worried about.

“The drugs prescribed have a lot of street value,” he said. “I’ve had instances where if a patient doesn’t keep their medication under lock and key, someone will come and take their pills. If patients believe someone is taking their medication I insist that they fill out a police report.”

Agnew said he believed only a very small subset of his patients — less than 1 percent — ever misused their medication or used their prescriptions recreationally. He advocates a more common-sense approach to assessing the prescription drug abuse pandemic.

“The perception is that it’s a bigger problem than in actuality,” Agnew said. “There is a great deal of fear about prescribing medication, but many people are under-medicated. I think before you start making persecutions about the misuse of drugs you need to be scientific.”

Noozhawk intern Tim Fucci can be reached at Follow Noozhawk on Twitter: @noozhawk or @NoozhawkNews. Connect with Noozhawk on Facebook.