Monday, October 1, 2007

Should Cancer Patients Use Narcotics to Ease Pain?

QUESTION: I suppose that everyone knows that drugs are addicting, but I
thought medications were supposed to be something else, to be used to help
people in pain. Now it is my mother that needs relief from her constant pain
from cancer. What do you think about allowing cancer patients to administer
narcotics to themselves to better control pain?
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ANSWER: Patient controlled analgesia (PCA) was developed in 1968 as a
technique whereby small amounts of intravenous narcotics can be administered
on demand by a patient-activated infusion pump. It was perfected because many
believe that pain-relieving requirements are difficult if not impossible to
predict and very decidedly different from patient to patient.
Recently a noted researcher reported that allowing a hospitalized patient
to decide when to receive pain medication is likely to reduce total narcotic
use and produce near-ideal pain relief while minimizing sedation and side
effects. Risks of accidental or deliberate overdose seems minimal since only
a tiny amount of drug can be delivered and a mechanized device controls the
interval between doses.
Other studies have shown that patient anxiety caused by having to wait a
specific amount of time or to continually ask for pain medication increases
the total drug requirement and may lead to addiction.
PCA seems to be an enlightened approach to analgesia, yet there are many
who find it a very hard concept to accept.

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