Journal of Clinical Pharmacology and Therapeutics
What Is Chronic Pain?
Pain is a complex phenomenon made up of physical, mental and social components. At a basic level, the ability to perceive pain has helped people survive throughout the ages. Without feeling the uncomfortable sensation when you touch a stove, which causes you to remove your hand, the heat from the stove would end up causing far more damage to the cells in your hand, than it did before you felt the pain.
In essence, pain is the body’s way of letting you know something is wrong. However, it is when pain fails to subside, despite removing the initial cause, that it become pathologic, and known as chronic pain.
Chronic pain can have a wide range of causes and can be associated with a number of different disease processes, thus the ability to diagnose chronic pain syndromes has been a widely debated topic within the medical community for many years.
Earlier this year, the American Pain Society, released a framework which attempts to account for all of the various factors that encompass chronic pain syndromes: physical, pathological, neurobiological, psychological, and social. Broadly speaking, however, the origins of chronic pain can be categorized into visceral (internal organs), somatic (skin and deep tissue), and neurogenic (nerves).
The Institute of Medicine reports that common chronic pain affects approximately 100 million Americans adults at a cost of $560-635 billion in direct medical treatment cost and lost productivity. However, while the impact of chronic pain is wide reaching across the population, its effect on the individual person is unique; there is variation in the source(s), severity, duration, response to treatment and psychological impact from person to person.
Conventional Therapies For Chronic Pain
Given the variety in the spectrum of chronic pain, it is no wonder why clinicians at times find difficulty in helping patients manage their chronic pain. This difficulty in management has contributed in part to the wide range of therapies which are used to treat chronic pain, such as aspirin, ibuprofen and other drugs which are classified broadly as non-steroidal anti-inflammatory drugs (NSAIDs) and can be purchased over over the counter.
These medications may work well for short term relief of mild to moderate pain, but they can create side effects such as ulcers and potentially damage the liver when used continuously, such as in a chronic pain scenario. It is for these reasons that most clinicians avoid relying on this type of medication for long term pain relief.
A more powerful alternative to NSAIDs are the opiates, such as morphine, oxycodone, codeine, and hydromorphone. The drugs have been well described in the scientific literature, and work by affecting the body’s natural opioid receptors to prevent the nerves responsible for sending pain signals from firing.
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Here's an interesting one.by Barcelo
I read through it real quick and it seems to make a good argument for both sides. This is an older article (1994), but this is the time when psychopharmacological drugs were being improved and it was still commonly accepted that psychotropic drugs were harmful or unnecessary.
The title is, 'The family therapist's guide to psychopharmacology: A graduate level course', written by Patterson, J.E & Magulac, M. Published in the Journal of Marital and Family Therapy in 1994 in the UK.
This is the first two paragraphs in case it is not found using Google:
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