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Only cancer patients themselves can accurately determine the level of pain
they are experiencing.
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Initial drug selection for the treatment of pain should be based on the
patient's description of pain intensity, and may require strong narcotics
from the outset.
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While alternatives to drug treatment, such as biofeedback, hypnosis, and
acupuncture can be effective for some types of pain, most patients will
require narcotics also.
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Addiction, as defined by psychological drug dependence, is extremely rare
when narcotics are used to treat cancer pain. Continued use of narcotics
to relieve pain is not the same as being a "drug addict."'
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Side effects such as nausea, vomiting, and constipation should be
anticipated and countered aggressively. Most side effects are transient
and are associated with the initiation of treatment.
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For persistent, continuous pain, drugs should be administered "by the
clock" instead of on an "as needed,"' or "PRN" basis. |
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The use of ineffective mixtures of weak narcotics and/or non-narcotic
analgesics to delay the use of narcotics should be abandoned. There are no
valid reasons to delay the use of strong narcotics if a patient is not
experiencing pain relief with non-narcotic analgesics. Placebos should not
be used.
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Drugs should be administered orally whenever possible, and intramuscular
injections, which themselves produce pain, should be avoided.
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Virtually all cancer-related pain can be relieved.
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