North Carolina medical journal
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This article reviews the public health consequences of current approaches to chronic pain management, particularly those related to prescription of opioid analgesics and other controlled medications. This article also reviews factors contributing to these negative trends and discusses potential strategies for reversing them.
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Opioid analgesics are commonly used for the management of chronic noncancer pain. Although they can be beneficial for select patients, opioids are also at the heart of a nationwide epidemic of misuse and diversion.
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Chronic pain and mental health: moving beyond the conceptualization of pain as the fifth vital sign.
Current approaches to the assessment and treatment of chronic pain continue to rely predominantly on the medical model. However, the comorbidity of chronic pain with psychiatric conditions underscores the need for a biopsychosocial and interdisciplinary approach to pain that can bridge the gap between scientific understanding and medical practice.
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Reducing suffering and helping patients to control their symptoms are key components of palliative care. This commentary will offer a comprehensive definition of palliative care and will present a case history to illustrate how palliative care can benefit patients with chronic pain.
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The use of opioids to treat chronic noncancer pain is controversial because of concerns about safety, efficacy, and the potential for addiction and abuse. Clinicians must therefore continue to seek out alternatives to opioids, such as nonsteroidal anti-inflammatory drugs, acetaminophen, muscle relaxants, benzodiazepines, and antidepressants.