Current pain and headache reports
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The problem of therapeutic opioid misuse largely affects patients who need opioids to treat chronic pain conditions. Opioid misuse is rarely an overt clinical problem during end of life or acute pain treatment. Misuse attaches a stigma to opioid use, and makes many patients and prescribers reluctant to use these uniquely effective drugs, even when misuse is unlikely. ⋯ However, cancer is no longer such an explosive disease, and many cancer sufferers can now expect to have a prolonged, even normal, lifespan. They may need pain treatment, but this treatment should not be modeled on palliative care paradigms. This article describes the underlying mechanisms of opioid dependence and its progression to addiction, and suggests a cautious approach to opioid treatment of chronic cancer pain that aims to minimize the problem of misuse.
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Curr Pain Headache Rep · Aug 2007
ReviewAssessment tools for the evaluation of pain in the oncology patient.
The control of cancer pain is an essential goal in the care of patients with cancer. Inadequate pain assessment by health care providers is a major risk factor for undertreatment of pain. Repeated and accurate pain assessment is required for optimal pain management. ⋯ In addition to measuring pain intensity, it is important to determine the impact of pain on patients' function, mood, and quality of life. Developmental issues must be considered when assessing the pain of children and elderly individuals with cancer. Novel technologies may be used to improve accurate and timely pain measurement.