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Doody's Review ServiceReviewer: Barry Egener, MD (Oregon Health and Science University)
Description: This is a comprehensive handbook for the pharmacologic treatment of pain. As well as offering practical suggestions for using traditional opiate and nonopiate analgesics, it discusses their potentiators, adjunctive therapies, and drugs with purported but unestablished efficacy, such as marijuana. Not only ignorance, but also attitudes and a misguided sense of morality are barriers to the relief of pain. This book combats all three by addressing their cognitive underpinnings. The book's major strength is the breadth of its treatment of the subject. It combines conceptual principles of pain management, addiction, and physiology with the details of basic anatomy, pharmacology, inappropriate prescribing, and special populations necessary for the rational treatment of pain.
Purpose: The purpose is to lessen the burden of unrelieved pain.
Audience: Because of the complex social issues that bear on the treatment of pain, this second edition's broad audience is the physician, the healthcare team, and the public at large. This perspective is consistent with the emerging biopsychosocial concept of disease: the notion that illness affects not only the patient, but all those in relationship to the affected individual. The challenge of writing for such a diverse group is balancing breadth and depth, being comprehensive without pedantic detail. For the most part, the book succeeds. The physician will find all the details necessary to competently use any pain reliever; the patient will find an explanation for the choice, drug interactions, and side effects.
Features: The excellent organization, table of contents, and index make it a practical reference text. The references and brand names are current. There are numerous figures and tables, although many of the latter are simple lists.
Assessment: What I found most interesting is how the book juxtaposes what is known about the treatment of pain with how medicine and society use that knowledge. The sections on drug dependence, the effects of emotion on pain, unrelieved pain, and governmental regulation are particularly relevant to the question of why physician and patient often choose to leave pain unrelieved. Because the audience is broad, the reader may need to consult one of the references to elucidate a particular detail, such as why one should avoid the common practice of combining over-the-counter analgesics. This book is an excellent resource for practitioners and patients advocating a more rational approach to pain management.