Pubdate: Thu, 19 May 2005 Source: Daily Press (Newport News,VA) Copyright: 2005 The Daily Press Contact: http://www.dailypress.com Details: http://www.mapinc.org/media/585 Author: Kathryn Hamilton MANAGING PAIN Recent reports of a local physician's legal and practice problems with the use of opioid medications makes for quick, catchy headlines. However, ongoing reports have failed to give perspective to the underlying problem. The emerging problem is how do physicians treat acute and chronic pain patients in today's regulatory and legal environment? Today's laws are little more than blunt instruments that leave every party to the decision of chronic pain treatment poorly served. Primary care doctors and their patients are especially left in a legal limbo. Precedent has already been set in North Carolina, Michigan and Oregon, where doctors have been sued by patients or their families for failing to use narcotic medications or "under-treating" for pain. Primary care physicians who have skills and resources to manage chronic pain in their patients may be put in an untenable situation should they choose to treat their patients. Concern for patients should never have to be compromised because physicians fear loss of livelihood and licensing. Pain may be an abstraction until it is lived, and many of us will have chronic pain conditions as we age. Newer delivery systems such as long-acting opiate medications are mainstays in the treatment of chronic pain. Morphine and its derivatives are morally neutral, just like blood pressure medications. Medications are typically only part of an overall treatment plan for patients with most types of chronic illness. Patients and their physicians have the right to no less than better laws and better pain management practices to combat this growing public health problem. KATHRYN HAMILTON Hampton - --- MAP posted-by: SHeath(DPFFLorida)