Journal of pain & palliative care pharmacotherapy
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A young man with acute maxillofacial injuries and a tracheotomy in intense pain was denied pain relief for several days. Intermittent suctioning of the trachea was agonizing. He became psychologically affected to such an extent that he was totally focused on his pain and suffering and unable to make intelligent decisions regarding his future treatment. ⋯ A doctor called in to counsel him found that pain was his predominant problem and treated it. The patient was magically transformed to a sensible person, now thinking straight and promptly consenting for surgery. The author, a doctor himself, learned from this experience what a devastating experience pain can have on the person, that one should look for pain to find it, that most of the time pain can be relieved by simple means, and that relief from pain changes the whole attitude of the sufferer.
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J Pain Palliat Care Pharmacother · Jan 2011
A first comparison between the consumption of and the need for opioid analgesics at country, regional, and global levels.
The objective of this study was to propose a rough but simple method for estimating the total population need for opioids for treating all various types of moderate and severe pain at the country, regional, and global levels. We determined per capita need of strong opioids for pain related to three important pain causes for 188 countries. These needs were extrapolated to the needs for all the various types of pain by using an adequacy level derived from the top 20 countries in the Human Development Index. ⋯ Only the populations of some industrialized countries have good access. Policies should seek a balance between maximizing access for medical use and minimizing abuse and dependence. Countries should aim to increase the medical consumption to the magnitude needed to address the totality of moderate and severe pain.
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J Pain Palliat Care Pharmacother · Jan 2011
Declaration of Montréal: declaration that access to pain management is a fundamental human right.
At the conclusion of the 13th World Congress on Pain in Montreal, Quebec, Canada, the International Association for the Study of Pain (IASP) hosted an International Pain Summit on September 3, 2010, to address the tragedy of unrelieved pain in the world. At the conclusion of the Summit, the delegates adopted a Declaration that Access to Pain Management is a Fundamental Human Right. That Declaration is presented.
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J Pain Palliat Care Pharmacother · Jan 2011
Opioid consumption in a tertiary hospital setting over an 8-year timeframe--a potential resource for tracking trends in pain management.
Opioid consumption by countries and health care organizations can be regarded as a marker of the quality of pain management. However, there are only limited data on opioid consumption in hospital settings. Objective and reliable data can be obtained by monitoring direct opioid consumption within a hospital, and then that data can be analyzed for identifying trends and directions to assist in guiding improved pain treatment within the hospital. This article tracks opioid consumption in a tertiary hospital over an 8-year period and by comparing the data to the consumption during the previous decade, it highlights trends and tendencies in the use of opioids as a potential indicator of pain management within this facility.
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J Pain Palliat Care Pharmacother · Jan 2011
The Fourth Amendment and random drug testing of people with chronic pain.
It is common for physicians who prescribe opioids for chronic pain to drug test their patients. This practice may soon be mandated by the State of Washington as a result of passage of their new law ESHB 2876. Random drug testing of people simply because they seek treatment for chronic pain arguably constitutes a suspicionless and warrantless search that violates both the Fourth and Fourteenth Amendments. Issues discussed include consent, circumstantial coercion, and "special needs" searches.