Abstract
The most important message that physicians must communicate to persons with chronic pain is that, currently, no medication exists that will take away more than 30% of the pain they experience. Chronic pain is a chronic disease and, like diabetes or hypertension, requires chronic concessions and lifestyle modifications. In controlled trials of short duration and small sample size with highly selected patients, patients sustaining moderate-to-severe pain still experience moderate pain even on opioid medication. Adverse drug effects are predictable and common, and, in fact, long-term compliance with opioids is low owing to side effects. Screening for substance abuse by history taking, observing behavior, obtaining old medical records,and using UDS in patients before initiating opioid therapy is important to identify patients with comorbid addictive disease who require coincident or antecedent treatment. Familiarity with federal and state controlled substance legislation and state health care provider and pain treatment acts is a mundane but essential educational endeavor for all physicians prescribing opioids. If physicians educate their patients with chronic pain about the limited efficacy of the medications, patients' expectatio...Continue Reading
References
Jan 1, 1985·The American Journal of Nursing·R F Kaiko
Dec 1, 1988·Pain·H L Fields
Jul 1, 1995·Journal of Pain and Symptom Management·N D de StoutzM Suarez-Almazor
Nov 1, 1994·Pain·D C TurkE A Okifuji
Jan 1, 1993·Spine·P B PolatinT G Mayer
May 1, 1996·Journal of Pain and Symptom Management·C S Hill
Mar 1, 1996·Journal of Pain and Symptom Management·S A Dunbar, N P Katz
Jun 20, 1998·Neurology·C P Watson, N Babul
Jun 20, 1998·Neurology·Y HaratiM Kamin
Oct 16, 1999·Acta Anaesthesiologica Scandinavica·A B ThomsenJ Eriksen
Oct 19, 1999·The Clinical Journal of Pain·D A FishbainR S Rosomoff
Feb 25, 2000·Journal of Pain and Symptom Management·S D PassikR K Portenoy
Mar 29, 2000·Anesthesia and Analgesia·N D Quang-CantagrelS K Magnuson
Jan 11, 2000·The American Journal of Forensic Medicine and Pathology·M G RippleJ E Smialek
Mar 10, 2001·Journal of Pain and Symptom Management·A M Gilson, D E Joranson
Sep 5, 2001·Journal of Pain and Symptom Management·N J AdamsE A Stauffacher
Feb 15, 2002·Journal of Pain and Symptom Management·David E JoransonJ David Haddox
Feb 28, 2002·Neurology·N AttalD Bouhassira
Oct 10, 2002·Neurology·S N RajaM B Max
Mar 26, 2003·Neurology·Joseph S GimbelRussell K Portenoy
Sep 23, 2003·Anesthesia and Analgesia·Nathaniel P KatzGilbert J Fanciullo
Oct 31, 2003·Journal of Pain and Symptom Management·Roger ChouMark Helfand
Nov 14, 2003·The New England Journal of Medicine·Jane C Ballantyne, Jianren Mao
Apr 23, 2004·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·C R GreenE Guerrero
Nov 25, 2004·Pain·Eija KalsoHenry J McQuay
Jun 24, 2005·The New England Journal of Medicine·J Kenneth Baillie, Ian Power
Citations
Jul 17, 2008·Der Schmerz·G-G Hanekop, F B M Ensink
Sep 1, 2006·Photomedicine and Laser Surgery
Jul 21, 2011·Journal of Anaesthesiology, Clinical Pharmacology·Deepak ThapaVanita Ahuja
Oct 12, 2012·Pharmaceutical Research·Brent B WardJames R Baker
Feb 2, 2016·The Journal of Pain : Official Journal of the American Pain Society·Mark D SullivanGary M Franklin
Dec 3, 2013·The Journal of Pain : Official Journal of the American Pain Society·Renu K GargGary M Franklin
Jul 22, 2008·Rheumatic Diseases Clinics of North America·Warren A Katz
Nov 13, 2008·Pain Practice : the Official Journal of World Institute of Pain·Bill McCarberg, Steven Stanos
Mar 20, 2008·Archives of Physical Medicine and Rehabilitation·Mitchell K FreedmanIra D Kornbluth
Jul 4, 2006·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·A Spacek
Jul 8, 2009·Pain·Constance M WeisnerMichael Von Korff
Aug 12, 2009·Journal of Pain & Palliative Care Pharmacotherapy·Sean D CandrilliShrividya Iyer
Dec 2, 2009·Journal of Pain & Palliative Care Pharmacotherapy·Rafael Galvez
Jun 15, 2017·Medical Care·Renu K GargGary M Franklin