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Editor's Note The journal is delighted to introduce a new feature in this issue that focuses on the complex and multifaceted issue of managing pain and related symptoms while responsibly attending to minimizing substance abuse. How should the seemingly disparate disciplines of drug abuse and symptom control interact? Should these be two separate fields or should practitioners/investigators in one also be qualified in the other? Is that even feasible? We are honored to have two leading, academically based clinician scientists coordinating this new feature. Peggy Compton is Professor and Associate Dean for Academic Affairs at the School of NursingHealth Studies, Georgetown University in Washington, DC. Many readers know of Peggy's work from her years on the faculty of the University of California at Los Angeles (UCLA). Peggy brings both clinical and scientific addictionology expertise as well as the invaluable perspective of nursing to this arena. Her collaborator is Michael F. Weaver. Mike is Professor of Psychiatry and Behavioral Sciences, and Medical Director of the Center for Neurobehavioral Research on Addictions, at the University of Texas Health Sciences Center at Houston. Prior to moving to Texas, Dr. Weaver became internationally known for his work in addiction medicine at the Medical College of Virginia. We look forward to detailed explorations of many interacting issues in symptom control and substance abuse in the articles featured in this new journal feature in coming issues. The commentary below, the article by Kanouse and Compton, the Issue Brief issued by the U.S. Department of Health and Human Services, and my editorial, all of which appear in this journal issue, introduce the new feature, which I am confident will make valuable contributions to the pain management and substance abuse literature. Arthur G. Lipman, Editor ABSTRACT Abusers of prescription opioids represent two distinct populations: those who develop addiction via opioids prescribed for pain, and those for whom prescription opioids represent a primary drug of abuse. Regardless of the pathway to abuse, outcomes for patients with untreated opioid addiction are poor, and consideration of the contextual factors surrounding their problematic use is critical to effective treatment. Reviewed are patterns of prescription opioid abuse among particularly vulnerable populations in underserved rural communities, and in an effort to prevent problematic use, principles of responsible opioid prescription for chronic pain are outlined so as to decrease the risk for developing addiction.

Perceived experiences of patients are important hallmarks of symptom control not only for physical symptoms, but also for the psychological, social, and spiritual dimensions. Listening to patients’ narratives opens window to diagnosing the patients’ symptoms. This reflection outlines the importance of this practice in managing symptoms of a terminally ill cancer patient.

Editor's NoteThe journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com.

The United States Pharmacopeia (USP) is the United States' congressionally authorized book of standards for pharmaceutical manufacturing in the United States. The most current edition of the USP includes a new chapter entitled Pharmaceutical Compounding-Sterile Preparations that sets standards for all health care professionals who prepare, store or dispense sterile preparations. Extemporaneously compounded sterile formulations are sometimes needed for symptom control in pain and palliative practice. The implications and relevance of this new USP chapter to pain and palliative care clinicians-and the importance of all clinicians understanding the implications of how their patient's compounded sterile products are prepared-are discussed.

World Wide Web (internet) resources that pertain to cancer support groups, especially pain and symptom control, are listed and reviewed. How to start using these services; services for patients, families, and friends; disease-specific websites; and other types of electronic information repositories are discussed.

This feature is based on actual questions and answers adapted from a service provided by the Hospice Foundation of America. Queries addressing the propriety of managing acute medical conditions in patients enrolled in a terminal care program and the mistaken belief that death from cancer is always painful are provided. Questions included in this set address management of acute medical conditions during end-of-life care, the lack of inevitability of pain with cancer, nutrition in advanced disease, managing panic attacks, and appropriate care for a dying 90 year old gentleman.

EDITOR'S NOTE The journal is delighted to begin a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com .

The hospice movement and palliative care programs have grown over the past quarter century at an astounding rate. Such programs now treat far more than just pain or cancer. Nevertheless, recognition of the critical need for improved cancer pain management was the genesis of modern palliative care. However, even today, many Americans lack ready access to such care. Recently, an increased focus on the need for more and better palliative care has led to important new publications, federal funding initiatives from palliative care research, and explicit recommendations from the National Cancer Policy Board on ways to lessen barriers to palliative care. Some of these potential solutions are discussed.

This paper introduces a new series in the Journal that will address Outcomes Research and Pharmacoeconomics in Pain & Palliative Care. The goal of the series is to provide an overview of the field of outcomes research that will be geared to clinicians, and to review the outcomes literature in the area of Pain and Palliative Care. This paper defines the common types of outcomes research that are relevant to pain and symptom control. There are a lot of misconceptions about the field including some who look at outcomes research as not really science and not adding to our knowledge about drugs and drug use. To the contrary, outcomes research is a powerful tool, but like many others it has limitations and it is important to understand both what outcomes research is, and what it isn't.

Editor's NoteThe journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com.

Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com .