Despite the ways in which both patients and health care professionals suggest that the health care system could do better at delivering the pain care that is available today, the overwhelming consensus of both groups is that new treatments are needed. While pain sufferers and providers are aware of the disadvantages of opioid medications, they often perceive a lack of adequate alternatives. “YES, we desperately need better medications,” one woman writes. Patients complain of feeling like “an experiment” or “a guinea pig” as treatment upon treatment is attempted without success. “We need better drugs, particularly those which act on the NMDA receptor pathways, substance P antagonists, etc.,” a provider writes. “One of the biggest problems with chronic pain, is that it isn’t a single disease with a few neat endpoints. When we did a national educational effort to encourage physicians to be more aggressive on treating pain, we [got] an epidemic of accidental overdoses.” An emergency room physician comments: “We need a systematic approach, not the ad hoc methods of US medicine. The best treatment is a functional system.” A psychotherapist writes simply: “I pray for more research to get to the bottom of this illness that is affecting so many people.”


The committee is deeply grateful to all those who shared their experiences and insights. The committee is mindful, too, of the fact that their testimony only scratches the surface of the challenges faced by pain sufferers and the people who help them. In receiving this testimony, the committee tried to bear in mind a poignant admonition offered by the American Pain Foundation: “for every letter you receive, consider the other THOUSAND PEOPLE who would love to write to you, but are too ill to do so.”

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