Adequate Pain Care Sorely Lacking

"They are hurried. They don't take time to listen. They're their least favorite patients to treat," he said.

Kirch, of the American Cancer Society, said doctors were concerned about possible "disciplinary action or criminal prosecution" for providing powerful painkillers. Patients and their relatives also suffer "fear and confusion about possible addiction to pain medicines," she said.

Effective painkillers such as morphine, codeine and other so-called "opioids" -- derivatives of opium poppies -- often are regarded as narcotics under federal and state regulations.

"The collision between the war on drugs and the war on pain has created a perfect storm of controversy," said Dr. Scott Fishman, the chief of the division of pain medicine at the University of California, Davis.

However, Rowe said that "opioids are some of the most effective and safe medicines when appropriately used."

"Addiction to opioids in the context of pain treatment has been reported to be rare in those with no history of addictive disorders," Heit said.

People are often reluctant to tell their doctors they're hurting because they're embarrassed and they think they should just put up with it, Driver said.

"Women don't seek pain relief as much as men," he said. "They fear being labeled as complainers."

Insurance is also a major problem for pain sufferers, the NIH's Berger said. Medicare doesn't cover most palliative care, and millions of people have no health insurance.

Besides opioids, pain specialists offer a variety of treatments to relieve suffering. According to Driver, they include nerve surgery, rehabilitation, anesthesia, psychological therapy, lifestyle changes and alternative medicine, including acupuncture, yoga and massage.