More than 50 million Americans live with chronic pain caused by various diseases or disorders. Each year nearly 25 million people suffer with acute pain as a result of injury or surgery.

How can this deplorable situation exist in a time when medical knowledge and technology are available to relieve or greatly ease most pain?

Fear.

Many doctors, and patients as well, fear using strong painkillers (a class of drugs called opioids) because they believe--wrongly--that they are addictive.

The fact is, when prescribed by a doctor and taken correctly, they are safe, effective, and rarely lead to addiction.

Here's what Dr. James Campbell, professor of neurosurgery at Johns Hopkins Medical Center, past president of the American Pain Society and chairman of the American Pain Foundation, has to say on the subject:

'Taking legal, FDA-approved opioid medications as prescribed, under the direction of a physician for pain relief, is safe and effective, and only in rare cases, leads to addiction.

'When properly used, these medications rarely give a 'high'--they give relief. And, most importantly, they allow many people to resume their normal lives.'

Pain management important
Fortunately, the management of pain is finally starting to achieve the status it deserves. Healthcare professionals, policy makers, the public and the media are becoming more aware of the undertreatment of pain and are beginning to take steps to address the problem.

For example, on Jan. 1, 2001, new pain standards adopted by the nation's largest healthcare accrediting organization went into effect. The standards are set by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). They now require all of the organization's 19,000 hospitals, nursing homes and other healthcare facilities to assess and treat pain. Furthermore, they are required to inform patients about their right to effective pain care. If they don't comply, they can lose their accreditation.

In spite of these advances, more than 50 million Americans still live with malignant or non-malignant chronic pain. And though most pain can be treated, it often goes untreated, improperly treated or undertreated.

For example, studies show that while cancer pain can almost always be relieved, more than 40 percent of cancer patients are undertreated for pain.

A more enlightened and humane approach to pain management, however, carries with it a burden of responsibility. Doctors and pharmacists need to be diligent in taking security measures to keep opioid medications out of illegal and improper hands.

Regulators and law enforcement officers must be tough in combating the illegal diversion of opioids to street trafficking. But they should do it in a balanced way that doesn't discourage the safe and legal use of such medications.

As the American Pain Foundation says: We must be careful not to turn the 'War on Drugs' into a 'War on Patients.'

Copyright 2002 by Dr. Phillip L. Polakoff and medical writer Jack Tucker/Press Associates news service.