Pain management in a drug-oriented society

Article Abstract:

Researchers are interested in society's influence on the use of drugs for medical purposes. Certain drugs are more "acceptable" than others for medical use due to the pervading attitudes of the society. The use of substances to relieve cancer-related pain, such as opioids, is strictly controlled by government agencies; the history of narcotics-related crime and addiction has influenced U.S. Government regulations that require a strict accounting by physicians when dispensing opioids used by cancer patients. Drugs that help relieve cancer-related pain are often incorrectly categorized with drugs that are abused by addicts. Studies have shown that larger doses of opioids are required by cancer patients in order to relieve moderate to severe pain. Current medical practice, however, routinely administers sub-optimal doses of pain-relieving agents to cancer patients. It is suspected that regulatory constraints play a role in inhibiting physicians from prescribing sufficient doses of these substances for use by patients at home. Authorities fear that if cancer patients receive larger doses of pain-relief agents, the medications may be divided among multiple users for illegal purposes, even though drug abuse among cancer patients is not a problem. Currently, physicians often write multiple prescriptions for the same narcotic substance used as a pain-relief agent. The patient then combines multiple-doses into a single, larger, dose. This cumbersome process could be alleviated if single, larger-dose prescriptions were legal. The drug abuse problem that now pervades society must not become a factor that influences the availability and appropriate use of narcotics by cancer patients.

Social aspects, Laws, regulations and rules, Dosage and administration, Compulsive behavior, Drug abuse, Narcotics, Medical law, Drug abuse and crime, Medication abuse, Prescription drug abuse

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Evaluation of dosing guidelines for the use of oral controlled-release morphine (MS Contin tablets)

Article Abstract:

Use of opioid substances is an important means of controlling moderate to severe cancer-related pain. Opioids, such as controlled-release oral morphine sulfate (MS Contin tablets, MSC) taken every 12 hours, have proven to be more effective than conventional oral morphine, which is usually administered every four hours. Physicians are often reluctant to administer adequate doses of MSC because they fear the possibility of overdosing patients, which may lead to unacceptable side effects (e.g., nausea, drowsiness, confusion, constipation, vomiting). In most cases, guidelines for the establishment of "adequate doses" do not exist. Several clinical trials, using MSC for cancer pain, are currently being conducted to establish more precise dosing guidelines. Preliminary results show that MSC dosing guidelines employed by researchers achieved total or satisfactory pain relief in about 75 percent of the patients, without causing significant side effects. Researchers who speculate that it is possible to safely administer slightly higher concentrations of MSC in order to achieve even greater levels of pain relief advocate the use of precise dosing guidelines and frequent contact between patients and physicians.

Management, Drug therapy, Heroin, Morphine

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Similar abstracts:

• Abstracts: Psychiatric management of cancer pain. Continuity of care for the cancer patient with chronic pain. Controversies in cancer pain: medical perspectives

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