The use of non-narcotic drugs and other alternatives for analgesia as part of a comprehensive pain management program.

Chronic pain remains an enigma which mystifies the most experienced clinicians. The traditional approaches to malignant pain employ narcotic analgesics, radiotherapy, surgical intervention, and chemotherapy. Within the context of a "therapeutic community" oriented pain unit, we attack this major public health problem differently. The use of non-narcotic analgesics, mood altering medications, various forms of psychotherapy (individual, group, family, gestalt, psychomotor) and peer pressure when used in conjunction with various physical modalities of treatment (including biofeedback, transcutaneous electrical nerve stimulator, physical therapy, whirlpool, massage, ice, heat, etc.) appear most efficacious. Frequently, the powerful tools of psychological medicine are taken for granted; yet, depression in the United States is widespread and so significantly complicates medical illness that any treatment program designed for pain patients must be holistic in its orientation if it is to be effective.