‘Zero pain is not the goal’ of medical treatment, doctors say


As doctors contemplate a future without opiates to treat chronic pain, some are making the case that eliminating their patients’ pain is not only impossible, it’s unnecessary.

“Zero pain is not the goal,” Dr. Thomas H. Lee, chief medical officer of the healthcare consulting firm Press Ganey, wrote in a commentary published Tuesday in the Journal of the American Medical Assn. “The reduction of suffering is — and that is something more complex than analgesia alone.”

That view flies in the face of attempts by doctors to suppress their patients’ pain as much as practically possible. These efforts helped fuel a surge in prescriptions for opiate painkillers, such as OxyContin, Percocet and Vicodin

The popularity of these medications has been blamed for surging rates of opiate addiction and death in the United States, prompting the Centers for Disease Control and Prevention to issue new guidance urging doctors to reserve the medications for patients with acute cancer pain, those receiving palliative care and those in their final days of life. For treatment of chronic pain due to conditions like arthritis and back problems, doctors instead should try Tylenol, Advil or other non-addictive therapies, the guidelines recommend.

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