This is SCIENCE IN THE NEWS, in VOA Special English. I'm Bob Doughty.
I'm Barbara Klein. Today we tell about
developments in pain control.
As recently as the nineteen seventies, little research existed
about a subject that interests most people at some time. The subject is pain.
the years, however, medical studies have led to new hope for patients who are
hurting. And an international movement
known as hospice has helped bring attention to difficult-to-treat pain for the
Doctors speak of three kinds of pain: acute, chronic
and breakthrough. Acute and chronic pain
can be mild or severe. Acute pain happens
fast and usually lasts a short time. It generally
reacts to treatment.
chronic pain can last a long time. Chronic
pain may go away, but it often comes back. It can be hard to treat.
Breakthrough pain is a pain that strikes suddenly. It may end just as suddenly. An activity can cause breakthrough pain. It also may happen as the effects of a
person's last medicine are ending.
Many different diseases, conditions and injuries can
cause chronic pain, from back problems to burns. Cancer is one of those causes, whether from
the disease itself or from its treatment. The Sloan-Kettering Memorial Cancer Center in New York City has been a
leader in pain research and treatments linked to cancer.
center's Doctor Kathleen Foley has been responsible for part of that gain. In the nineteen seventies, a supervisor asked
her if she would like to do clinical research about pain. She was completing her medical education at
the center at the time.
Foley wanted to do the research. But she
said she did not know anything about the subject. The head of the center's office dealing with
the nervous system said nobody else knew about it, either.
As part of her duties, Kathleen
Foley studied treatment of patients dying of cancer in the hospital. She found that the treatment was far from satisfactory. She said patients were often not given
medicine to control pain until they were suffering badly. And, their pain could be eased only by
Foley brought together experts in medicine, drug treatment and basic research to
find better methods. A laboratory was created
to study recently discovered opiate receptors in the brain.
published mainly in nineteen seventy-three had found proteins on the surfaces
of nerve cells in the brain. The
findings made it possible to better study pain drugs and learn how they affect the
many doctors order pain medicines for dying patients to be given before
suffering takes hold. And more methods
of administering the medicines are now available. One is a pump that lets
patients give themselves pain medications as needed. They cannot harm themselves because the
amount of painkiller in the pump is carefully measured and limited.
Doctor Foley notes another development in pain care. It is the continual monitoring, or
observation, of patients' conditions. A
continually monitored person is not left alone to suffer.
Kathleen Foley was named to head Sloan Kettering's new
Pain Service within the Department of Neurology in nineteen eighty-one. It was America's first such hospital medical
service to identify itself this way. Today,
the Sloan-Kettering Cancer Center operates a pain and symptom-control service
for all its cancer patients.
An international movement called hospice also has
greatly improved pain care for the dying. Hospice care helps people whose doctors confirm that they have only a
limited time to live. These patients suffer
from a number of sicknesses and conditions.
Hospice care can be given in hospitals, centers
for patients and older adults, and patients' homes. Doctors, nurses, social workers and others work
with patients and their families to raise the quality of a patient's last days. These medical experts are trained in the safe
administration of pain-killing drugs. Their
use can prevent or greatly reduce suffering.
Hospice care may have begun in Europe's Middle
Ages. In those days, religious workers
cared for sick travelers at shelters near holy places.
Centuries later, a British
doctor became an activist for better care for the dying in the nineteen
forties. With financial aid, Cicely
Saunders established Saint Christopher's Hospice in London. She studied pain management efforts in the
United States, which she said were better than those of Britain. Her efforts met a longtime need. News of her work traveled.
Another woman, Josefina B. Magno, helped
the hospice movement grow in the United States. She was able to get the government and insurance companies to help
patients with the cost of their care. Doctor
Magno established the Hospice of Northern Virginia with friends in nineteen
seventy-seven. She later led the
National Hospice Organization.
care is not limited to the dying. Patients still receiving active treatment for diseases like cancer and
AIDS can also get hospice help. They can
receive palliative care to ease the signs of their sickness. The need is clear in many areas.
An organization called the
Foundation for Hospices in Sub-Saharan Africa operates
from the city of Alexandria, Virginia. The Foundation says seven thousand people die in parts of Africa every
day from conditions resulting from the disease AIDS.
The group recently announced seven new partnerships
between centers in Africa and the United States. For example, the Center for Hospice and
Palliative Care in South Bend, Indiana joined with the Palliative Care
Association of Uganda. The new
partnerships are among seventy-three such active relationships in fifteen
African countries and twenty-seven American states.
American experts held a three-week training class in Ukraine about pain
control. Doctor Frank Ferris directs a
hospice in California. Mary Wheeler is a
nurse at a hospice in Washington. They
provided information to Ukrainian health workers about patient care.
The two Americans presented training in controlling pain, advising patients and
families, and understanding and administering medication. They have been invited to present similar
information in Jordan, Egypt, Mongolia, Saudi Arabia, Georgia, Moldava and Vietnam. America's National Cancer Institute is among
financial supporters of these efforts.
of some kinds of pain medicine are restricted. Doctors must first contact a drugstore to order the medicine for their
patients. The order is called a
Doctors usually prescribe opiate drugs only for
patients with severe pain. Opiates
include codeine, methadone and morphine. Most of
these narcotic drugs come from the poppy flower. People have used one opiate, opium, for pain
for more than two thousand years. A
newer drug, oxycodone, is called an opioid. An opiod is similar to an opiate. Doctors use it to control moderate to severe pain over a long
doctors prescribe narcotic drugs for patients with lasting severe pain. Such drugs may ease suffering. But they can also be addictive. The user may need increasing amounts to get
the same effect.
drugs must be taken carefully. People can
accidentally kill themselves by taking too many pills or mixing medicines. Sometimes this happens when a person takes
drugs and also drinks too much alcohol.
The Journal of the
American Medical Association recently published a study of unplanned deaths
from prescription drugs. The study reported
about deaths in the rural state of West Virginia. The report said about sixty-six percent of
those who died there from prescription drugs apparently had no
of the drugs were painkillers. The report said methadone was involved in
forty percent of the deaths. The drug
has been used for many years to treat addiction. It is often given to addicts to reduce symptoms
of withdrawal from opiods like heroin.
Strong painkillers, then, can do great good. They ease suffering for millions of patients every
year. But some people abuse them, and abusing
painkillers can be like riding a wild animal.
This SCIENCE IN THE NEWS
program was written by Jerilyn Watson. Our producer was Brianna Blake. I'm Bob Doughty.
Barbara Klein. Join us again next week
for more news about science in Special English on the Voice of