Managing pain: The Challenge in Underserved Populations: Appropriate Use Versus Abuse and Diversion.
OBJECTIVE
Inadequate pain management is a serious public health problem that affects a wide cross-section of Americans. Patients are often denied sufficient medication, because physicians lack training and fear scrutiny from federal and state regulatory agencies. In addition, even the state-financed system of care, Medicaid, has been increasingly denying payment for the best treatment for pain management. These factors are complicated by physician bias about various subgroups and poor physician-patient communication. Comprehensive patient assessment plays a crucial role in determining appropriate treatment and identifying potential abuse problems. Physicians must routinely document medications analgesic effects and screen for potential ill effects and drug abuse.


OBJECTIVE
To examine the prevalence of the undertreatment of pain, particularly among African Americans, and to recommend relevant proactive policy and practice changes to aid in eliminating this health problem.


METHODS
In July 2002, the NMA convened the "Managing Pain: The Challenge in Underserved Populations: Appropriate Use versus Abuse and Diversion" Consensus Meeting in Washington, DC. The country's most renowned experts in the area of pain management and substance abuse reviewed substantial information regarding pain management and substance abuse including the following: --A draft summary paper on pain management and substance abuse that served as briefing material for consensus members; --Annotated bibliographies; --Articles on pain management and substance abuse; and --Key presentations on pain management and substance abuse.
Primm
Benny J
BJ
Addiction, Research and Treatment Corp., Brooklyn, NY, USA.
Perez
Lucille
L
Dennis
Gary C
GC
Benjamin
Lennette
L
Clark
Westley
W
Keough
Kathy
K
Leak
W David
WD
Payne
Richard
R
Smith
Deborah
D
Sullivan
Louis W
LW
D001741:Black or African American; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002983:Clinical Competence; D004335:Drug and Narcotic Control; D006801:Humans; D009293:Opioid-Related Disorders / Q000208:ethnology* / Q000517:prevention & control; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology*; D010147:Pain Measurement; D014481:United States
D000701:Analgesics, Opioid