A recommendation for doctors to treat pain as a ‘fifth vital sign’, coupled with a profit-driven pharmaceutical industry and a consumer culture created a perfect storm

Twenty-two years ago, in 1996, the influential American Pain Society introduced the concept that pain should be treated as a “fifth vital sign”, alongside the normal things doctors routinely check in their patients body temperature, blood pressure, heart rate and breathing. America’s medical profession broadly welcomed the idea and began to ask patients routinely how much pain they were in.

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