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Pain management in a drug-oriented society
1Department of Neuro-Oncology, University of Texas System Cancer Center, M.D. Anderson Hospital and Tumor Institute, Houston 77030.
Cancer
|June 1, 1989
Summary
Physicians fear prescribing adequate narcotic pain relief due to societal confusion and legal ambiguity surrounding drug use. Revising statutes and educating the public can improve cancer pain management.
Area of Science:
- Pharmacology
- Oncology
- Public Health Policy
Background:
- Societal attitudes often conflate recreational drug abuse with legitimate medical use of narcotics.
- Restrictive legislation and societal mores impact the prescription of controlled substances.
- Cancer pain management is frequently hindered by these societal and legal factors.
Observation:
- Physicians may hesitate to prescribe high narcotic doses or sufficient quantities for severe pain.
- Fear of investigation for prescribing practices can lead to suboptimal pain management strategies.
- Cancer patients with pain rarely abuse prescribed narcotics.
Findings:
- Inadequate cancer pain treatment stems from societal confusion between legitimate and illicit narcotic use.
- Vague legal definitions of drug use (e.g., 'addicts') contribute to physician apprehension.
- Physicians may prescribe multiple, lower-dose narcotics instead of single, higher-dose prescriptions for simplicity and perceived safety.
Implications:
- Revising and standardizing state statutes regarding drug use is crucial.
- Physicians should advocate for improved social attitudes towards narcotic pain control.
- Addressing physician fear through education and policy reform can enhance patient care for severe pain.