MANAGING PAIN

Recent reports of a local physician's legal and practice problems with
the use of opioid medications makes for quick, catchy headlines.
However, ongoing reports have failed to give perspective to the
underlying problem. The emerging problem is how do physicians treat
acute and chronic pain patients in today's regulatory and legal
environment?

Today's laws are little more than blunt instruments that leave every
party to the decision of chronic pain treatment poorly served. Primary
care doctors and their patients are especially left in a legal limbo.
Precedent has already been set in North Carolina, Michigan and Oregon,
where doctors have been sued by patients or their families for failing
to use narcotic medications or "under-treating" for pain. Primary care
physicians who have skills and resources to manage chronic pain in
their patients may be put in an untenable situation should they choose
to treat their patients. Concern for patients should never have to be
compromised because physicians fear loss of livelihood and licensing.

Pain may be an abstraction until it is lived, and many of us will have
chronic pain conditions as we age. Newer delivery systems such as
long-acting opiate medications are mainstays in the treatment of
chronic pain. Morphine and its derivatives are morally neutral, just
like blood pressure medications. Medications are typically only part
of an overall treatment plan for patients with most types of chronic
illness. Patients and their physicians have the right to no less than
better laws and better pain management practices to combat this
growing public health problem.

KATHRYN HAMILTON

Hampton