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Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic

Pain management in the United States reflects attitudes to those in pain. Increased numbers of disabled veterans in the 1940s to 1960s led to an increased focus on pain and its treatment. The view of the person in pain has moved back and forth between a physiological construct to an individual with...

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Detalles Bibliográficos
Autores principales: Bernard, Stephen A, Chelminski, Paul R, Ives, Timothy J, Ranapurwala, Shabbar I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311547/
https://www.ncbi.nlm.nih.gov/pubmed/30626997
http://dx.doi.org/10.1177/1178632918819440
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author Bernard, Stephen A
Chelminski, Paul R
Ives, Timothy J
Ranapurwala, Shabbar I
author_facet Bernard, Stephen A
Chelminski, Paul R
Ives, Timothy J
Ranapurwala, Shabbar I
author_sort Bernard, Stephen A
collection PubMed
description Pain management in the United States reflects attitudes to those in pain. Increased numbers of disabled veterans in the 1940s to 1960s led to an increased focus on pain and its treatment. The view of the person in pain has moved back and forth between a physiological construct to an individual with pain where perception may be related to social, emotional, and cultural factors. Conceptually, pain has both a medical basis and a political context, moving between, for example, objective evidence of disability due to pain and subjective concerns of malingering. In the 20th century, pain management became predominately pharmacologic. Perceptions of undertreatment led to increased use of opioids, at first for those with cancer-related pain and then later for noncancer pain without the multidimensional care that was intended. The increased use was related to exaggerated claims in the medical literature and by the pharmaceutical industry, of a lack of addiction in the setting of noncancer pain for these medications—a claim that was subsequently found to be false and deliberatively deceptive; an epidemic of opioid prescribing began in the 1990s. An alarming rise in deaths due to opioids has led to several efforts to decrease use, both in patients with noncancer conditions and in those with cancer and survivors of cancer.
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spelling pubmed-63115472019-01-09 Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic Bernard, Stephen A Chelminski, Paul R Ives, Timothy J Ranapurwala, Shabbar I Health Serv Insights Perspective Pain management in the United States reflects attitudes to those in pain. Increased numbers of disabled veterans in the 1940s to 1960s led to an increased focus on pain and its treatment. The view of the person in pain has moved back and forth between a physiological construct to an individual with pain where perception may be related to social, emotional, and cultural factors. Conceptually, pain has both a medical basis and a political context, moving between, for example, objective evidence of disability due to pain and subjective concerns of malingering. In the 20th century, pain management became predominately pharmacologic. Perceptions of undertreatment led to increased use of opioids, at first for those with cancer-related pain and then later for noncancer pain without the multidimensional care that was intended. The increased use was related to exaggerated claims in the medical literature and by the pharmaceutical industry, of a lack of addiction in the setting of noncancer pain for these medications—a claim that was subsequently found to be false and deliberatively deceptive; an epidemic of opioid prescribing began in the 1990s. An alarming rise in deaths due to opioids has led to several efforts to decrease use, both in patients with noncancer conditions and in those with cancer and survivors of cancer. SAGE Publications 2018-12-26 /pmc/articles/PMC6311547/ /pubmed/30626997 http://dx.doi.org/10.1177/1178632918819440 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Perspective
Bernard, Stephen A
Chelminski, Paul R
Ives, Timothy J
Ranapurwala, Shabbar I
Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic
title Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic
title_full Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic
title_fullStr Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic
title_full_unstemmed Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic
title_short Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic
title_sort management of pain in the united states—a brief history and implications for the opioid epidemic
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311547/
https://www.ncbi.nlm.nih.gov/pubmed/30626997
http://dx.doi.org/10.1177/1178632918819440
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