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April 17, 1987

Painful Prescriptions

JAMA. 1987;257(15):2081. doi:10.1001/jama.1987.03390150097044

Mary and her husband were looking forward to spending more time together since he had retired. At age 63, however, she developed esophageal cancer. Mary was referred to a cancer center in another city where she was treated with surgery and irradiation. After treatment she continued to have persistent mediastinal pain, which deprived her of sleep and depressed her appetite. Mary lost weight and was always tired and irritable; her daily living activities were a burden. Her family physician prescribed a mild narcotic-containing analgesic that didn't help. On the next visit to the cancer center a strong narcotic was prescribed that provided adequate relief. Mary slept and ate better and enjoyed life again. When her supply of the narcotic was gone she requested a prescription refill from her family physician; he refused. He explained that he didn't have the triplicate forms required by state law to prescribe schedule II narcotics,