Personalized Pain Program Offers Individualized Treatment Plans for Patients with Chronic Pain

"Everyone experiences pain differently," says Johns Hopkins psychiatrist Traci Speed.

A colorful, abstract silhouette of a human being with scratchy lines in brain area to show pain
Published in Brain Wise - BrainWise Winter 2025

Traci Speed is pretty sure that very few of her patients with chronic pain have ever spent more than 10 or 15 minutes talking about their pain with a physician.

“Primary care doctors don’t have the capacity to spend a lot of time learning about a patient’s pain,” she says. “It’s a big problem and it’s part of the reason so many people don’t get the right care for chronic pain.”

The Johns Hopkins assistant professor of psychiatry and behavioral sciences spends at least an hour with patients when they turn to the Personalized Pain Program (PPP), a collaboration between the Department of Psychiatry and Behavioral Sciences and the Department of Anesthesia and Critical Care Medicine, for help with chronic pain related to surgery.

“Some of these patients have been using huge doses of opioids to manage their conditions,” says Speed. “For others, after surgery, this is the first time they’re experiencing things like loss of sleep or difficulties performing everyday tasks.”

“When we work with people who’ve lived for years with chronic pain, it’s absolutely critical that we explore areas like depression, anxiety and post-traumatic stress.” 

Traci Speed
Traci Speed in physician's white coat, smiling for a formal portrait.

She says by the time most people with chronic pain seek help from a psychiatrist, they’ve likely seen numerous practitioners and tried many treatments, often without much benefit.

“There’s often a feeling that they’ll never live without pain,” Speed says.

Learning about the person is crucial to understanding their pain, Speed says. The PPP includes anesthesiologists, human factor engineers and others who have studied pain and its many complexities.

“When we work with people who’ve lived for years with chronic pain, it’s absolutely critical that we explore areas like depression, anxiety and post-traumatic stress,” she says. “Psychiatric comorbidities, whether they started before or after the pain, can make treating pain much more complex.”

Mainly, patients in the Personalized Pain Program have orthopaedic or traumatic injuries, such as gunshot wounds, which require surgery, as well as neurological, gastroenterological, cardiothoracic or vascular pain. Established in 2017, the program is available by referral from Johns Hopkins physicians for patients who are taking opioids for chronic pain and who had or will soon undergo surgery.

Speed says she sees many patients whose pain affects their mental health.

“‘Pain catastrophizing’ is a big obstacle for a lot of people,” she says, referring to the psychological distress that often accompanies long-standing pain. “When I work with them, I listen to their stories and their experiences with pain. The frustration and hopelessness can really make things worse.”

Nearly 60% of the PPP’s patients are unemployed or disabled. Many are members of underserved communities. A significant percentage of patients worked jobs that required intense physical labor that left them vulnerable to injury.

“The goal is to use an individualized approach to help patients regain and maintain function, improve their quality of life and effectively manage their pain by addressing their mental health, enhancing personal ability, teaching healthy behaviors and instilling hope for a successful recovery,” Speed says.

Speed’s research focuses on the relationships between neuropsychiatric symptoms, such as trouble sleeping, and chronic pain. Most recently, she has published research examining the integration of psychiatric care into multidisciplinary pain management.

“Everyone experiences pain differently,” Speed says. “We’re learning more all the time, but there’s still so much we don’t know in the field of pain management. There’s not just one treatment approach.”