Because of new insights from research, the field of pain medicine is booming.

	Steve Mellon/Post-Gazette
	Patients at Mercy Hospital are urged to let doctors and nurses know if they are having pain.

"The exciting thing is that people now want to treat pain," says Dr. Doris Cope, director of the Pain Medicine Division at University of Pittsburgh Medical Center, who also oversees clinics in Shadyside and at St. Margaret's, Magee-Womens and Presbyterian hospitals.

This is long overdue, experts say.

"There is an appropriate treatment for pneumonia, for example. Why not say this about pain management?" asks Dr. Susan Tolle, who directs the Center for Ethics in Health Care at Oregon Health Sciences University, which teaches clinicians about the need to assess and treat pain across all medical disciplines.

Among the developments:

Governments and agencies are beginning to require pain assessment and treatment; JCAHO's "fifth vital sign" requirement is part of the first national standards requiring pain assessment and management in all hospitals and nursing homes.

State licensing agencies are beginning to investigate their physicians not only for overprescribing of pain medications, but now for the undertreatment of pain.

Congress has declared the 10 years beginning in 2000 the Decade of Pain Management. Several states have passed their own intractable pain treatment acts requiring aggressive treatment and in some cases stipulating that physicians who appropriately prescribe opioids are protected against scrutiny.

Physicians' and patients' reluctance to use strong pain medications such as opioids is declining.

All of this action has filtered down to patients, who are storming the region's many pain treatment programs.

"We've grown from five patients per week to hundreds," says Cope.

Dr. John Keun-Sang Lee, director and founder of the Jefferson Pain and Rehabilitation Center, which practices acupuncture and other complementary therapies, says his program sees upward of 3,000 patients a year.

Dr. Jack Kabazie, an anesthesiologist at West Penn who also is founder and president of the Pittsburgh Pain Society, says his programs are inundated, seeing close to 7,000 inpatients and 7,500 as outpatients a year; his youngest patient is 13 and his oldest is 95.