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What Is Adequate and Appropriate Pain Treatment?

Steven R. Brenner, MD
JAMA. 1996;275(17):1310. doi:10.1001/jama.1996.03530410024015.
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To the Editor.  —Regarding the recent Editorial by Dr Hill about adequate treatment of pain,1 in my experience physicians are not unwilling to prescribe opioids for pain relief. Rather, in treating patients with back pain, headaches, and other pain syndromes, I have often found that patients have received large doses of narcotics on a chronic basis, while nonnarcotic means of pain relief have not been fully used, in spite of the poor response patients with many of these conditions have to narcotics.On the other hand, physicians may be hesitant to prescribe narcotics for chronic pain syndromes since physicians have lost their licenses because they were "easy marks."2 Drugseeking patients feign illnesses and may become quite angry if denied medication.2 Diversion of prescription drugs into the illegal drug market is a major problem in the United States and Canada, with about 15% of all prescription drugs dispensed


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