Part 1 of 3...Chronic pain robs people of their dignity, personality, productivity and ability to enjoy life

From: Helen Dynda (olddad66@runestone.net)
Wed Apr 30 12:28:16 2003


X> Part 1 of 3...Chronic pain robs people of their dignity, personality, productivity and ability to enjoy life ..... >From the New York Times.....by Jane E. Brody...January 22, 2002

http://www.nytimes.com/2002/01/22/health/anatomy/22BROD.html?ex=10131908 76&ei=1&enºa9c35fc871f0a9 .....(I was unable to access this article at this Url.)

Chronic pain suffered by 30 million Americans robs people of their dignity, personality, productivity and ability to enjoy life. It is the single most common reason people go to doctors, contributing to an overall cost to the economy of billions of dollars a year.

Yet chronic pain, whether caused by cancer or a host of nonmalignant conditions, is seriously undertreated, largely because doctors are reluctant to prescribe - and patients are reluctant to take - the drugs that are best able to relieve persistent, debilitating, disabling pain that fails to respond to the usual treatments.

These drugs are called opioids, which are natural and synthetic compounds related to morphine, generally known as narcotics. Many studies have indicated that ignorance and misunderstanding seriously impede their appropriate use.

Studies suggest that about half of patients with cancer-related pain and 80 percent of those with chronic noncancer pain are undertreated as a result. These patients suffer needlessly, as do their loved ones.

"Some patients who experience sustained unrelieved pain suffer because pain changes who they are," say Dr. C. Richard Chapman of the University of Utah School of Medicine and Dr. Jonathan Gavrin of the University of Washington School of Medicine.

Chronic pain, they wrote in The Lancet medical journal, results in "an extended and destructive stress response" characterized by brain hormone abnormalities, fatigue, mood disorders, muscle pain and impaired mental and physical performance.

Neurochemical changes caused by persistent pain perpetuate the pain cycle by increasing a person's sensitivity to pain and by causing pain in areas of the body that would not ordinarily hurt.

"This constellation of discomforts and functional limitations can foster negative thinking and create a vicious cycle of stress and disability," the researchers wrote. "The idea that one's pain is uncontrollable in itself leads to stress. Patients suffer when this cycle renders them incapable of sustaining productive work, a normal family life and supportive social interactions."

Dr. Jennifer P. Schneider, a specialist in addiction medicine and pain management in Tucson, Ariz., agrees. "When patients feel hopeless and think they will never get relief, it makes chronic pain and its effects that much worse," she said in an interview.


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