the joint commission developed this pain as the 5th vital sign. as part of a grant of that was provided to them by the pharmaceutical company purdue pharma the joint commission on accreditation of health care organizations recently defined and adopted stringent pain standards on the basic thrust of our new standards is that organizations and practitioners have an obligation to ask the patient even if the patient doesn't look like he or she is in pain ask them be surprised to hear when you go to a doctor's office how they ask you or are you having pain. no you may go for a raise that has nothing to do with pain which just added lighter fluid to the fire because because it became equivalent to say if you have pain you need opioids they're making at least in the united states you know 2 plus 1000000. you know i mean probably not they're making 2 plus 1000000 on them produce marketing depending on how you look at it very successful very tragic all the marketing legislative maneuvering cash and free giveaways handed to doctors and politicians might have been justified if opioids were a safe effective non-addictive treatment for chronic pain but they we