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).”