[Noozhawk’s note: The original version of this article contained several errors related to professional affiliations and has been corrected below. This story is part of Day 9 in Noozhawk’s 12-day, six-week special investigative series, Prescription for Abuse. Related links are below.]
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.”