Pain experts discuss drug dependence, tolerance at attorneys general seminar

NEWS IN BRIEF — Posted Oct. 25, 2004

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Physical dependence on and tolerance to opioids are not the same as addiction. That was the message two prominent pain experts told state law enforcement officials at the National Assn. of Attorneys General's End of Life Health Care Seminar held Oct. 5 in suburban Chicago.

"Pain is man's oldest problem and medicine's newest specialty," said American Pain Society immediate past President Richard Payne, MD, director of the Institute on Care at the End of Life at Duke University in Durham, N.C.

Dr. Payne said he has seen patients who were "absolutely mutilated" with back surgeries and nerves cut when all they really needed was medication. He also said policy measures that try to restrict the availability of certain controlled substances "are not a good thing for clinicians" because one of the drugs that these policies often seek to restrict is methadone, which Dr. Payne described as an "excellent pain medication" that costs only pennies a day for treatment.

David Joranson, director of the Pain and Policy Studies Group at the University of Wisconsin in Madison, noted that 16 states have measurably improved their pain treatment policies since his institution first reported on the issue four years ago. But, while policy has gotten better, he said, "regulatory scrutiny -- as perceived by many -- has worsened."

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