Chronic pain

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From time to time, every physician has to deal with the patient with chronic, intractable pain. Evidence of the increasing frequency of this problem is the development, in the past decade, of chronic pain clinics and centers. The director of one such center said, “This is a good paper, quite useful to every professional.” Drs Bakris and Zorumski discuss the pharmacologic management of chronic pain with regard to mechanisms of action and efficacy. In their view, most chronic pain patients do not require narcotic analgesics. Many can be maintained on antidepressant drugs alone, if any medication is required. The authors also describe the operant behavior approach, as utilized in a behavioral medicine/pain therapy center.