PUBLIC HEALTH AND POLICY ISSUES ? Absenteeism Represent ...

There is evidence that more and more acute and chronic pain are to attract the concerted attention of policymakers and the public. Chronic pain represents a considerable drain on the health care system. Okifuji, Turkish, and Kalauokalani estimated that more than 90 million Americans suffer from some form of persistent or recurrent pain. Health care costs and indirect costs associated with disability compensation and lost productivity resulting from absenteeism represent huge sums of money. More than $ 125 billion is estimated to be expended annually on health care to treat people with chronic pain! The concern of gaps in our understanding of pain and pain control has led the U.S. Congress to designate the first decade of the 21st century "The Decade of Pain Control and Research." It is hoped that there will be greater attention to the provision of psychological services for people suffering from pain, given the central role of psychosocial factors in pain and suffering. This lack of attention for a long time 320 CRAIG AND Hadjistavropoulos represented a problem traditionally community health care has emphasized the medical aspects of patient care rather than psychological and social factors. Inadequate pain seems to be a particularly serious problem for special populations, or persons with disabilities. It also appears to be a need for improvement in handling complaints of pain and disability that have not a clear explanation of physical pathology, these conditions must be recognized as serious problems. Many administrative agencies require objective evidence of biological dysfunction, if benefits are to be given to the person. The fears of the impact of analgesics often limit their use or access to their use. Complex controls evaluation and approval of drugs in the United States and Canada appear to be sensitive. But the concerns of law enforcement, legislators, and others about substance abuse has led to a disturbing reluctance to prescribe these drugs effective. Similarly, fears of side effects of opioids led to great reluctance on their use in infants and young children and others. Fortunately, monitoring the impact of opioid treatment is easily accomplished and the risk of morbidity was considered minimal. Many now believe that there are greater risks associated with the administration of opioids than those not associated with their use under careful medical supervision. There is also a real problem with the diversion of prescription painkillers for illicit purposes. OxyContin, for example, is a controlled-release opioid. Drug traffickers have succeeded in breaking the barrier timerelease this formulation and it has become a favored street drug, despite the significant risks of addiction and overdose. All these factors contributed to the doctors of being subjected to high levels of supervision of their prescribing practices and the risks of workplace bullying when they prescribe opioids for noncancer pain. This has led to the pain management poorquality for many people with chronic pain who would benefit from prescription opioids.

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