Strong analgesics: working towards an optimal balance between efficacy and side effects

Inadequately treated chronic pain remains a major cause of suf- fering. A recent survey found that moderate to severe chronic pain affects 19% of adult Europeans. Other large scale surveys in Australia, Denmark and Norway have given similar results. These also represent a substantial socioeconomic burden. Moreover, these surveys may underestimate the true incidence, because many patients paradoxically re- port their analgesia to be satisfactory despite being in pain. One study found that over 75% of patients declared themselves satisfied or very satisfied with their overall pain management, despite al- most 50% reporting recent moderate to severe pain