ABSTRACT

The management of persistent pain in primary care is complicated and time

consuming. Despite a growing knowledge about the pathophysiology of pain,

management remains an elusive goal. When surveyed, only 34% of internists

reported that they felt comfortable with their abilities to manage patients with

persistent pain (1). Increasingly, opioids have been used to treat persistent

noncancer pain. Recent IMS data shows that hydrocodone products are the most

widely prescribed drugs in the United States, largely from primary care (2). In a

recent article, Ballantyne and Mao wrote that the most difficult issue now facing

by physicians is “. . .whether and how to prescribe opioid therapy for chronic pain that is not associated with terminal disease, including pain experienced by

the increasing number of patients with cancer in remission (3).”