On the other hand, medicine’s embrace of expanded opioid use and the influence by pharmaceutical companies on that use 8 has had unintended consequences. 5 According to Cheatle and Savage, “ne of the barriers to effective pain management across the spectrum of pain conditions … is the clinician’s fear of prescribing opioids beyond that merited by the actual risks.” 6 Efforts in 1990s to lessen barriers to appropriate opioid use did result in decreased suffering for some patients. 4 Although opioid prescriptions are only one aspect of effective pain treatment, the failure to utilize opioids in appropriate circumstances causes suffering and creates a barrier to effective pain care.
2 The inadequate treatment of pain was the subject of significant clinical and policy efforts in the 1990s 3 among those efforts were the increased use of opioids for acute pain and the use of long-term opioid therapy for patients with chronic pain. On the one hand, relief from suffering is a primary obligation of physicians, and pain remains undertreated after decades of improvement efforts. Physicians are understandably conflicted about how, when, and whether to prescribe opioids. They are widely feared compounds, which are associated with abuse, addiction and the dire consequences of diversion they are also essential medications, the most effective drugs for the relief of pain and suffering.” 1
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