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by Russell K. Portenoy, M.D.
Relief Efforts. Americans spend more than $100 billion annually seeking relief from chronic pain and reverse its negative effects on sleep, social life, physical functioning and work performance. One of the most effective treatments also is among the most controversial: opioid drugs. Stigmatized by their connection to substance abuse, opioids are often feared by patients, inadequately stocked by pharmacists and used too sparingly by physicians. But long-term opioid therapy should be the first line of treatment among some groups – such as those with advanced cancer, where chronic pain occurs in more than two of every three patients. It's also clearly appropriate for those with AIDS or other serious medical illnesses, and for selected patients with severe chronic nonmalignant pain, such as low- back pain, headache and neuropathic pains.
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Pain – especially chronic pain – is now being recognized as the serious health problem it is. Although still undertreated, patients who suffer chronic pain – about one in every seven Americans – should not bear it stoically. For the past few years, forces have been gearing up across the medical community to recognize pain – and do something about it.