quate doses of opoid analgesics, causing patients unnecessary discomfort. Wide clinical experience shows that psychological dependence rarely occurs in cancer patients receiving these drugs for chronic pain (World Health Organization, 1986, 56). J. Andrew Billings, M.D., suggests that it is cruel to imagine that cancer patients are abusing drugs when "they need and deserve good painkillers to lead a decent life" (1985, 18).
Apparently physicians commonly underestimate the duration of action of a drug. This error results in a patient who never really experiences adequate pain control. Hospitalized patients usually have their pain medication ordered for an interval longer than the drug will be effective. This practice causes the pain intensity to increase during the over-extended period. The dose is insufficient, and pain control is difficult (Gunn, 1984, 151). This ineffective rhythm requires that the patient feel pain before receiving each medication. Also, practically speaking, personnel shortages in hospitals almost guarantee that there will be a delay in receiving medication on time.
Nurses and doctors, at times, become suspicious of patients who ask for narcotics. These patients may be marked as behavioral problems, hedonists in search of a fix. One nurse was observed to banter, "Ha, ha, you are going to become a real drug-addict" while administering, medication to a terminally ill cancer patient (Billings, 1985, 18). This suspicion of undue drug use is unwarranted. Euphoria is rarely seen in cancer patients receiving narcotic analgesics. Patients whose pain reliever has worn off are understandably unhappy. They return to a normal state after receiving medication (Gunn, 1984, 151). It seems most ef
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