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   More than 34 million Americans live with daily chronic pain, which often prevents them from enjoying fully active lives. But now a new survey reveals that many of these people may be suffering needlessly.
   According to the survey, which was released by the American Pain Society and the American Academy of Pain Medicine, more than four out of every ten people with moderate to severe chronic pain have yet to find adequate relief, and describe their pain as "out of control."
   "Many Americans with chronic pain are suffering too much for too long and need more aggressive treatment," said Russell Portenoy, MD, president of the American Pain Society. "Most of these patients could benefit if provided with state-of-the-art therapies and improved access to pain specialists when needed."
   All the individuals surveyed had experienced pain for at least six months and described their pain as being a 5 or higher on a scale of 1-10, with 10 being "the worst pain imaginable."
   The source of their pain was split between arthritis, back disorders and other causes, excluding cancer.
   A majority of respondents reported difficulty with such basic activities as sleeping, doing chores at home and walking.
   Although more than half reported suffering from pain for more than five years, only 22 percent had been referred to a specialized pain treatment program or clinic, which offers a multidisciplinary approach to care.
   "Pain that persists and impairs a person's ability to be productive and enjoy life often requires evaluation and treatment by a team of pain specialists," says Dr. Portenoy. "But too often, patients don't seek out this option because they're not aware of it, and physicians don't refer them."
   According to the survey, among patients who changed doctors, a significant percentage did so because their doctor didn't take their pain seriously enough or treat it aggressively enough.
   Despite the fact that opioid drugs, such as morphine and the fentanyl skin patch, were rated the most effective treatments by those who used them, these medications were seldom used.
   Only 26 percent of the respondents with very severe pain reported taking opioid medications at the time of the survey. While opioid drugs are not suitable for all pain patients, experts agree that some patients benefit greatly.
   "This survey shows the stigma associated with opioid drugs. Although these drugs can clearly benefit some patients with chronic pain, patients, caregivers and physicians overestimate the risks and fail to use them appropriately," says Dr. Portenoy. "Many patients suffer needlessly because of an inappropriate level of concern about addiction caused by strong pain medications, such as opioids."
   Medication is only one of many strategies used to treat pain and the disability that may accompany it. Both drug and non-drug therapies may be used.

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