NEW YORK--An interdisciplinary approach is key to helping American medicine face the "analgesic dilemma,"
David Joranson, MSW, said at a media briefing on pain sponsored by the American Medical Association and Ortho-McNeil Pharmaceutical.
Physicians and patients must grapple with the choice between effective pain relief and exposure to the undesirable side effects associated with commonly available pain relief options, including excessive sedation and fear of addiction.
The answer lies in a combination of modalities: physical and behavioral therapy, psychosocial interventions, and medication. "Underutilization of medication and the failure to use medication in combination with other effective interventions is a significant problem in the United States, and it is especially serious in treatment of cancer pain," said Mr. Joranson, associate director for policy studies, Pain Research Group, University of Wisconsin, Madison.
Mr. Joranson, whose research focus has been policies regulating the availability of opioid analgesics, believes that addiction issues have been overemphasized. "When opioids are used carefully in carefully selected and monitored patients, addiction risk is minimal, especially in cancer patients." He decried the fact that uninsured patients may get less intense pain treatment than insured patients.
Ca Patients Suffer from Pain Myths
Underutilization of opioid analgesics is particularly unjustified in cancer patients, who suffer from many myths about pain and cancer that make physicians reluctant to prescribe effective doses of medication. Among these, he said, are that pain medications are often addictive when given postoperatively; that pain is an inevitable consequence of cancer; and that if used too early or too often, pain medication won't work later.