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Substantial material added to address the current social, political, economic, and ethical perspectives related to pain management and prescription drug abuse, including impact on prescribers and patients. Bibliography expanded and updated.

Updated on 02 Dec 2013. The previous version of this content can be found here.
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date: 25 March 2017

Abstract and Keywords

Pain is a multidimensional, subjective experience that embodies the complex relationship of body, mind, emotions, and spirit. Assessment begins with the patient’s report and is enhanced by diagnostic tools, skilled inquiry and observation of behavioral, physical, cognitive and emotional responses. Pain may be acute, chronic, intermittent, or persistent and can be related to a chronic condition or progressive life-threatening illness—all of which may lead to significant psychological, spiritual, functional, and socioeconomic consequences. The undertreatment of pain is well documented and ubiquitous, especially in vulnerable populations, including the elderly, infants and children, and ethnic minorities. Inadequate management of pain has been the focus of national and international research and policy and relates to many variables, including the controversy and concerns about the use of opioids which are classified as controlled substances. This classification creates a unique environment of legislative, regulatory, and law enforcement scrutiny most recently exacerbated by the public health focus on the abuse of prescription medications. Pain is a clinical, ethical, policy, and advocacy issue. Advocating for state of the art pain management is a shared responsibility of professionals whose ethical codes include social justice, beneficence, and commitment to vulnerable populations.

Keywords: pain, acute, chronic, suffering, delegitimization, undertreatment, public policy, addiction, vulnerable populations, opioids

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