I. Barriers from health care providers A. Inadequate assessment by physicians B. Lack of knowledge of current treatment by providers C. Backward philosophy of practitioners 1. Cancer pain that occurs with disease progression is expected 2. Prescribing opioids only for dying patients 3. Patients’ pain complaints are unreliable D. Reluctance of physicians to prescribe opioids 1. Fear of prescribed restrictions 2. Fear of overprescribing with more Responsibility 3. Increased workload in administering opioids Ⅱ. A. Fear of addiction to “narcotics” B. Reluctance to discuss pain with physicians C. Fear of acknowledging that pain represents progression of disease Barriers from the health care system A. Lack of collaboration for effective pain management B. Lack of dedicated resources for pain management