NEW YORK—In a paper released today, a leading neurologist specializing in pain and palliative care said that many of the more than 50 million people in the United States living with chronic pain forgo effective treatment with prescription medication due to misperceptions and fears of addiction.

Dr. Kathy Foley, M.D., who authored the lead piece in the "Ideas" paper published today by the Open Society Institute, said that fear of addiction to pain medications were largely fed by sensationalized media reports documenting the illegal abuse of OxyContin and drugs that would otherwise safely treat people suffering from pain.

"By highlighting OxyContin's illegal use, we fail to educate the public about the role such analgesic drugs play in providing relief for millions of patients suffering from severe pain," said Dr. Foley, the director of OSI's Project on Death in America.

Dr. Foley, who is also a leading neurologist at Memorial Sloan Kettering Cancer Center and a professor of Neurology, Neuroscience, and Clinical Pharmacology at Cornell University Medical College, added that misconceptions about these drugs have influenced attitudes and behaviors not only of patients, but pharmacists and health care professionals who report fear of addiction as a major barrier to effectively treating pain patients.

"When physicians and patients confuse tolerance and physical addiction, patients become stigmatized and pain therapy is threatened," Foley said.

According to Dr. Foley, patients taking opioids on an ongoing basis may become physically dependent; if they stop taking the drug abruptly, they may show signs of withdrawal. However, slowly tapering a patient off the drug eliminates these symptoms. She clearly differentiates this from addiction, the term used to characterize behaviors of compulsive drug use despite harm.

Studies have demonstrated that children, women, and patients with cancer, AIDS, sickle cell disease, and arthritis have been needlessly under-treated for pain; over 35 percent of elderly patients living in nursing homes have inadequate treatment for their pain, based on international standards of the World Health Organization. And minorities, particularly African Americans and Hispanics, are also at substantial risk for untreated pain, although differences in access to care and medications and variation in the quality of medical attention play a role.

The economic impact of pain on society is estimated at over $100 billion per year in treatment costs, workmen's compensation costs, lost wages and missed days of work, which Dr. Foley said is largely avoidable. She adds that unrelieved pain interferes with all aspects of life, diminishing activity, appetite, sleep, social interactions and can lead to depression, feelings of anxiety, and hopelessness.

The paper also documents some encouraging signs that pain management is finally starting to achieve the status it deserves in healthcare and public policy. Hospitals and healthcare facilities must now assess, monitor, and manage pain in all patients or risk losing their accreditation, and pain has now been designated as a fifth vital sign to be recorded along with blood pressure, pulse, respiratory rate, and temperature.

Also included in the Ideas paper is an up-close look at the Pain and Policy Studies Group, (PPSG) a program of the University of Wisconsin Medical School, and a World Health Organization Collaborating Center for Policy and Communications in Cancer Care. They have undertaken the only systematic analysis of the international, national, and state regulations that impact pain management with analgesic drugs, and created public policy guidelines within which physicians can practice adequate pain management without fear of investigation.

Increased media coverage of the abuse of pain medications makes PPSG's work even more relevant today as people search for balanced ways of responding to diversion without interfering with patient care.

"Our vision is that people who suffer from cancer, AIDS, surgery, accidents, and chronic conditions will have relief from their pain and a better quality of life, and that caregivers will know when and how to use opioid analgesics without fear of regulatory agencies," said David Joranson, Director of the PPSG.

"Ideas," an occasional paper from OSI, debates provocative and innovative strategies for social change to advance democratic and open society values. Current and past issues of "Ideas for an Open Society" are available on the web at www.soros.org or in hard copy by contacting info.USprograms@sorosny.org.

Note to reporters and assignment editors: more information on pain management and palliative care and interviews with Dr. Kathy Foley, M.D. are available by contacting Amy Weil at aweil@sorosny.org or 212-548-0381. OSI also maintains a list of grantees that are available to write op-eds and provide information on the issue.

The Open Society Institute, a private operating and grantmaking foundation, is part of the network of foundations, created and funded by George Soros, active in more than 50 countries around the world.

OSI's U.S. Programs seek to strengthen democracy in the United States by addressing barriers to opportunity and justice, broadening public discussion about such barriers, and assisting marginalized groups to participate equally in civil society and to make their voices heard. OSI U.S. Programs challenges over-reliance on the market by advocating appropriate government responsibility for human needs and promoting public interest and service values. OSI U.S. Programs supports initiatives in a range of areas including access to justice for low and moderate income people; judicial independence; ending the death penalty; reducing gun violence and over-reliance on incarceration; drug policy reform; inner-city education and youth programs; fair treatment of immigrants; reproductive health and choice; campaign finance reform; and improved care of the dying.