THE WAR ON PAINKILLERS

To the Editor:

Re "Misunderstood Opioids and Needless Pain" (Jan. 22): The drug war
has turned pain into an American epidemic. Those of us who suffer the
asinine puritanical response of the morality police appreciate the
rare column inches given to our situation.

We've all read plenty of nonsense about OxyContin. Bet your bottom
dollar that the pontificating politicians and D.E.A. agents advocating
more restrictions on pain prescribing will find the strongest drugs
available when they need them! Pain control must be loosened across
the board, so regular folks can get relief when we need it. We cannot
now; I can vouch for that. This drug war is an evil thing.

DAVE MICHON
Eau Claire, Wis.

To the Editor:

As a physician who specializes in pain management, I recognize that
many patients with chronic pain can benefit from opioids and either do
not receive them or receive inadequate doses ("Misunderstood Opioids
and Needless Pain"). This often reflects physician ignorance about the
proper use of these medications. However, this problem is not limited
to opioids alone.

All types of pain including those that respond better to non-opioid
analgesics are as poorly managed.

But the column also suggests that opioids and other drugs are
mainstays of pain management and that other interventions like
psychologically based techniques and physical and occupational therapy
are merely adjuncts.

Some of us in the field, backed by recent research, disagree with the
premise that opioids alone or with some limited additional
interventions will help a majority of patients with chronic pain.

DR. STEVEN A. KING
New York

The writer is with the Pain Center at the Hospital for Joint
Diseases.

To the Editor:

Experts are reluctant, for good reason, to always use opioids
("Misunderstood Opioids"). Human pain is very complicated. Each person
must be seen as unique to find the best treatment.

From my experience working at a tertiary pain center, I agree that
there is an "abundance of misinformation" in the medical marketplace
about pain, but opioids are no panacea.

ROBERT HAMEL
Ann Arbor, Mich.