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Perspectives
in Intractable Pain Management:
An analysis of current divering viewpoints |
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Kristin Bundy
For the National Foundation for the Treatment of Pain |

Patients' Perspective
One out of six households in America contains a member
with severe, intractable pain.1 Unfortunately, most of these
patients go undertreated because healthcare providers do not provide adequate
amounts of opioids to relieve their pain.
Ironically, some patients also perpetuate their own
undertreatment of pain because they:
Whether patients report their pain or not, however,
undertreatment of pain is usually inevitable. Eventually, unrelieved pain
patients may head into a downward spiral of depression4-8
and, perhaps, begin to consider suicide.4,5,9,10
The New Paradigm creates a new
transition in thought that educates patients about pain treatment,
empowers patients to seek appropriate relief, and helps patients avoid
depression and thoughts of suicide.
Reference List
- The Mayday Fund. New survey finds broad support
among Americans of physicians prescribing high doses of pain medication,
such as morphine, for severe pain. Available at: http://www.pain.com/news/Mayday.cfm
- Barnebei R, et el. Management of pain in elderly
patients with cancer. JAMA. 1998;279(23):1877-1882.
- Patients Face Numerous Barriers to Receiving
Appropriate Pain Treatment. American Medical Association (News Release,
July 1997). Available at: http://www.ama-assn.org/sci-pubs/sci-news/1997/
snr0716.htm#briden
- Brownlee S, Schrof JM. The Quality of Mercy.
US News & World Report. 1997;122(10). Available at: http://www.usnews.com/usnews/issue/970317/17pain.htm
- Sullum J. No Relief in Sight. Reason. 1997;28(8).
Available at: http://www.reasonmag.com/9701/fe.jacob.html
- Marks EM, Sachar EJ. Undertreatment of medical
inpatients with narcotic analgesics. Ann Intern Med.
1973;78:173-181.
- The painful dilemma: the use of narcotics for
treatment of chronic pain. Sacramento, CA, Sacramento-El Dorado Medical
Society, 1990.
- Angarola RT, Wray SD. Legal impediments to cancer
pain treatment. In: Hill CS, Fields WS, eds. Advances in Pain Research
and Therapy. Vol 11. New York, NY: Raven; 1989:213-231.
- Pain Killer [transcript]. "60 Minutes."
CBS television. May 25, 1997.
- Gorman C. The case for morphine. Time.
1997;149(17). Available at: http://www.pathfinder.com/time/magazine/1997/dom/970428/
medicine.the_case_for.html
- Wells N, Johnson RL, Wujcik D. Development of
a Short Version of the Barriers Questionnaire. J Pain Symptom Manage.
1998;15(5):294-298.
- Thomason TE, McCune JS, Bernard SA, et al. Cancer
Pain Survey: Patients-Centered Issues in Control. J Pain Symptom
Manage. 1998;15(5):275-284.
- Bostrom M. Summary of the Mayday Fund Survey:
Public Attitudes About Pain and Analgesics. J Pain Symptom Manage.
1997;13(3):166-168.
- Hale KL. Cancer pain treatment: overcoming the
barriers. MD Anderson Oncolog. 1995;40(3). Available at: http://www.mdacc.tmc.edu/~oncolog/manage.html
- Melzack R. Tragedy of Needless Pain. Sci Am.
1990;262(2):27-33.
- Ravenscroft PJ. Use of opioids in treating chronic
pain. Available at: http://www.win.bright.net/%7Edavidk/opioduse698.htm
- Gianelli DM. Controlling chronic pain: groups
release guidelines for opioid use. American Medical Association (News
Release, March 1997). Available at: http://www.ama-assn.org/special/hiv/newsline/special/
amnews/amn0317.htm
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