Despite outstanding educational efforts by many international organizations devoted to improving pain management, not all patients receive adequate care. One cause for under-treatment includes the unfounded fear by physicians who order opioids that addiction to these important medications will automatically develop in their patients who take them. Recently, primary care physicians identified another issue—a need for more information when prescribing opioids.¹ 

The JAOA's current four-part supplement series is specifically devoted to providing physicians with information on an extremely wide variety of approaches designed to enhance analgesia. These approaches include surgical procedures, osteopathic manipulative medicine, pharmacologic options, and supportive care. 

Members of the clergy, physicians, and medical scientists have contributed to this updated pain management series. All four supplements have been revised to include new evidence-based knowledge and continuing medical education questions. Of special significance is that each article presents illustrative cases that will enhance primary care physicians' understanding of various approaches to treating not only patients who suffer, but also their devoted families and friends who participate in such care. This last supplement in the series features two new contributions by clergy members; they provide excellent insight of terminal patients whose discomfort is not always due to physical pain. 

For the first time, the American Osteopathic Association is publishing JAOA supplements only on-line. Providing information through this electronic medium streamlines the production process and absolutely increases distribution. 

I laud the dedication to this project by our guest supplement editors Karen J. Nichols, DO; Anthony H. Dekker, DO; Katherine E. Galluzzi, DO, and Gregory H. Pharo, DO. 

I thank Gilbert E. D'Alonzo, Jr, DO, AOA editor in chief; Michael Fitzgerald, director of publications, and Karen Bjorkman Stipp, assistant director of publications for JAOA, for helping me move this project from development to final production. Others who contributed to refining and enhancing this project include Leslie M. Huzyk, AOA creative director; Helen Samonte-Shippy, publications coordinator; and Jane M. Reiling, production manager. 

I also appreciate the educational grant provided by Purdue Pharma LP, which enabled the JAOA to provide this valuable series to all healthcare professionals who wish to improve their knowledge of pain management and thus offer their patients an improved quality of life.