PHARMACOLOGICAL MANAGEMENT OF CANCER PAIN IN RURAL MINNESOTA

Use of analgesic medications for cancer pain was assessed in six Minne sota communities. In, our survey cancer patients were treated primaril y by family practice physicians. Approximately 70% were given one or m ore analgesics; 84% received a nonsteroidal antiinflammatory drug and 73% received an opioid. Most patients given an antiinflammatory drug r eceived less than the maximal recommended dose for the drug. The most common opioid for cancer pain was oral morphine. Approximately 40% of the patients treated with opioids took the drug only when needed; the remainder took the drug around-the-clock, with or without additional o pioids for breakthrough pain. Only 14% of patients who received analge sics received a coanalgesic and only 13% received a nonanalgesic adjuv ant. The patterns of analgesic use in these communities corresponded w ell with accepted principles of cancer pain management: liberal use of opioids, use of oral morphine as the predominant agent, and avoidance of meperidine and opioid agonist/antagonists. (C) U.S. Cancer Pain Re lief Committee, 1996.