When Will Adequate Pain Treatment Be the Norm?

Inadequate treatment of pain continues to be a problem despite more knowledge about its causes and control and despite widespread efforts of governments and multiple medical and voluntary organizations to disseminate this knowledge, particularly at the postgraduate level. Of particular note are the recent publications of the Agency for Health Care Policy and Research of the US Public Health Service¹,²and educational and dissemination efforts of the American Cancer Society, the American Pain Society,³and cancer pain initiatives in many states. The Cancer and Palliative Care Unit of the World Health Organization (WHO) has emphasized pain relief for cancer patients in developing countries because of limited cancer treatment facilities there. Most cancer in these countries is advanced, and treating its pain is the only practical approach available. To address this problem by educating health care professionals, the WHO⁴developed an "analgesic ladder" for pain treatment, which uses