BUSINESSWEEK ONLINE : MARCH 22, 1999 ISSUE
READERS REPORT

There's More to Defeating Pain Than Designer Drugs


I read ''Conquering pain'' (Cover Story, Mar. 1) returning from India, where we are working with the government to reduce the barriers to using morphine to manage cancer pain. Opioid analgesics in the class of morphine are either unavailable or inadequately used in most of the developing world because of exaggerated fears of addiction and consequent excessive regulation.

Availability of opioids is particularly important in the developing world, where cancer is on the increase--and typically diagnosed only in late stage. You should recognize, as do the World Health Organization and public-health authorities throughout the world, that there is no substitute for opioids for managing such pain. The case for new analgesics should not be made by perpetuating the myth that ''narcotics'' are life-threatening and cause addiction. This only perpetuates the barriers to relieving pain from cancer and other chronic diseases.

David E. Joranson
Director Pain & Policy Studies Group
Comprehensive Cancer Center
University of Wisconsin Madison


I was surprised that your article contained references only to medicinal and pharmacologic treatment of pain. It left out hypnosis and other alternative methods. Even more surprising was this quote from Dr. John T. Farrar, a neurologist at the University of Pennsylvania Medical School: ''We have to find some way to harness that ability of the mind to control pain.'' To the best of my knowledge, hypnosis has been considered an accepted therapy by the American Medical Assn. since 1958.

Janet L. Macy
Lake Forest, Calif.


There's a price tag that makes these wonder drugs unavailable to the vast majority of pain sufferers. My sister, who is only 41, has rheumatoid arthritis but cannot afford the $1,000-plus per month that Immunex Corp. charges for Enbrel, one of the drugs you mention. Enbrel purportedly will not only reduce her pain and give her back a life but also arrest permanent bone damage. Her rheumatologist tells me that none of his patients can afford this miracle, nor will insurance companies participate in coverage for many of these new drugs. It's a shame that patients have to suffer when a ''cure'' exists.

Brenda Everett
Danville, Calif.


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