Medical schools do not provide sufficient curriculum time to pain
management nor do most residency programs.
Solution: Encourage medical schools to prioritize teaching pain management per
"best practice" as recommended by the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO)2 and also provide educational workshops for
physicians already in practice.
Problem: Even when properly informed, doctors are often afraid to follow "best
practice" guidelines for patients who require large amounts of medication or even
to accept pain patients out of fear of being targeted by the Drug Enforcement
Solution: Seek another doctor if your prescription fails to relieve your pain. If you are
unable to obtain adequate medication, complain to your senators and congressman
and urge them to investigate the DEA's failure to respect "best practice" and persecution
of conscientious physicians. (Conscientious physicians tend to attract extreme
chronic pain sufferers, and hence prescribe greater quantities of opioids in general
and huge doses to some patients as warranted. Thus they attract the scrutiny of
overzealous DEA agents and prosecutors who either don't understand "best practice"
or are seeking headlines to divert attention from their overall failure to prevent
wide scale criminal diversion of licit and illicit drugs.)
Problem: Many patients suffer needlessly because they are either too stoic to
complain or they mistakenly fear addiction.
Solution: Educate patients about the importance of reporting unrelieved pain,
and make them aware that opioid treatment is rarely addictive.
Problem: Loved ones often underestimate the debilitating effects of chronic pain
and discourage taking dosages as prescribed.
Solution: Involve family members in pain treatment consultations. Make them aware that
their loved one's pain affects the entire family and can be successfully treated medically.