Evidence map›Paper›PMID 30626997›Full record

ArticleHealth services insights2018

Management of Pain in the United States-A Brief History and Implications for the Opioid Epidemic.

Stephen A Bernard, Paul R Chelminski, Timothy J Ives, Shabbar I Ranapurwala

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health services insights, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Trends in acupuncture billing by a large commercial insurer.The American journal of managed care · 2026
    Article
  5. Review
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  18. Multimodal Pain Management in Orthopedic Surgery.Journal of clinical medicine · 2022
    Review
  19. Article
  20. Public Perceptions of Opioid Use Following Orthopedic Surgery: A Survey.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Stephen A BernardSchool of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.ORCID https://orcid.org/0000-0001-7688-9852
Paul R ChelminskiSchool of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Timothy J IvesSchool of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Shabbar I RanapurwalaGillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pain management in the United States reflects attitudes to those in pain. Increased numbers of disabled veterans in the 1940s to 1960s led to an increased focus on pain and its treatment. The view of the person in pain has moved back and forth between a physiological construct to an individual with pain where perception may be related to social, emotional, and cultural factors. Conceptually, pain has both a medical basis and a political context, moving between, for example, objective evidence of disability due to pain and subjective concerns of malingering. In the 20th century, pain management became predominately pharmacologic. Perceptions of undertreatment led to increased use of opioids, at first for those with cancer-related pain and then later for noncancer pain without the multidimensional care that was intended. The increased use was related to exaggerated claims in the medical literature and by the pharmaceutical industry, of a lack of addiction in the setting of noncancer pain for these medications-a claim that was subsequently found to be false and deliberatively deceptive; an epidemic of opioid prescribing began in the 1990s. An alarming rise in deaths due to opioids has led to several efforts to decrease use, both in patients with noncancer conditions and in those with cancer and survivors of cancer.

Indexed as

cancer survivorship and pain managementopioid deathsopioid epidemicpain and disability in politics in the United Statespain management in patients with cancerPain management in the United Statespolitical impact in the United States on pain management

Identifiers

PMID30626997
PMCPMC6311547

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.