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Agree: WHO Needs Updating Elmer G. Pinzon, MD, MPH Knoxville, Tennessee I agree that the outdated WHO pain ladder diagram (1986), although very beneficial in its day, is in need of some modifications, as proposed by Drs. Pergolizzi and Raffa.
Editor’s Note:The World Health Organization (WHO) Pain Ladder has been an enduring guide for over 25 years. Its simple, progressive steps of 1) anti-inflammatory agents, 2) weak opioids, and 3) strong opioids is still fundamentally sound. In this article, Pergolizzi and Raffa present a thoughtful and detailed set of recommendations to modify the 3-step process.
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