Pain Care and treatment: When will adequate pain treatment be the norm?

From: Helen Dynda (olddad66@runestone.net)
Mon Jan 13 15:49:58 2003


X> Pain Care and treatment: When will adequate pain treatment be the norm? (Editorial) ... JAMA, The Journal of the American Medical Association, Dec. 20, 1995 http://members.aol.com/imagine524/painabstr.htm

" Efforts to improve pain management usually focus on educating physicians. However, it is not clear whether this will change their behavior. Medical schools should include pain management in their undergraduate curricula. Hospitals can also develop quality improvement programs to improve their management of pain. Patients should demand appropriate pain relief in light of evidence showing that few hospital patients become addicted to painkillers.

"All types of pain in all parts of the world are inadequately treated, be it acute or chronic, related to malignant or nonmalignant etiologies. Probably more patients suffer needlessly from pain of nonmalignant origin than do patients from pain of cancer.

"Medical school curricula are woefully lacking in teaching medical students treatment of acute pain and the complexities of chronic pain treatment.

"There is no question that physicians are compassionate individuals who want to provide adequate pain treatment for their patients.

"Bringing about significant change may, in reality, depend on empowering patients to demand adequate pain treatment, regardless of what that treatment may require.

"Currently, if a patient who has experienced pain relief with opioids demands them, even for cancer pain, that patient can expect health care professionals to accuse him or her, either overtly or by innuendo, of being a drug abuser. Patients must challenge this accusation and demand respect for their position. Patients must be taught that health care professionals' knowledge on this subject is derived from the same source as their own and is largely based on cultural biases, prejudices, and misinformation rather than on scientific data.

"Patients should also know that scientific data show that almost all patients with painful medical conditions requiring opioids for treatment discontinue their use after the medical condition for which opioids were needed no longer exists. Patients do not like to confront their health care providers; however, if a valid health care provider-patient relationship exists, the strategies just mentioned should not threaten it.

"Achieving adequate pain control must go beyond educating health care professionals and become an issue in monitoring the quality of patient care. If adequate pain relief using these methods still does not become the norm, patients must be empowered to demand adequate relief, regardless of the cause of the pain or the methods required to achieve relief. In all situations, relief of pain, either acute or chronic, must be the standard for success."

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