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To the Editor: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) pain management standards, as outlined in the Medical News and Perspectives by Mr Phillips,¹ are flawed. In allowing treatment of chronic nonmalignant pain to be included as a "patients' rights" issue, physicians may be pressured to prescribe opiates in cases in which this is inappropriate.

The article states that there are 50 million people in the United States with chronic pain and 26 million with back pain. Elsewhere, it has been established that nearly 50% of the population reports having chronic pain,² and back pain occurs in as much as 80% of the population.³ It was stated that there is no "excuse" for not treating these patients with opiates when they are not satisfied with nonnarcotic pain relievers.

Beyond simple physiologic dependence, patients with chronic pain are at substantial risk for drug abuse and addiction. Prescription drug abuse . . . [Full Text of this Article]

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JCAHO Pain Management Standards Are Unveiled
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