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8 The prevalence of chronic pain in Italy is approximately 26%¹, a level indicative of a need for improvement in its treatment. When compared with other European countries the use of opioids in Italy is considerably lower. Use of opioids in Italy in comparison to main European Countries In an attempt to improve the situa- tion, legislation was introduced in March 2010 with the aim of impro- ving the education of physicians and simplifying the prescription of opioids. Under Law 38/2010² pain assess- ment is now a required duty of cli- nicians along with a differentiation between pain therapy and pallia- tive care. With the aim of impro- ving access to pain therapies, drug prescription was simplified and the year later an audit showed that this new legislation had produced only a partial improvement; only 63% of hospitals had a Pain Therapy and Palliative Care Unit, the response being particularly poor in the south of the country. Under the CHANGE PAIN® umbrella a PAIN EDUCATION program has been launched in Italy with the fol- lowing key objectives:  To reduce the gap between Italy and other European countries in terms of pain treatment and edu- cate on opioids and their appropri- ate prescription  To drive the simplification of opioid prescription for GPs and spe- cialists according to Law 38/2010 The first part of his national program was aimed at training the trainers, prescription of opioids no longer requires special forms. This law was the first in the occiden- tal world to recognise the citizen’s right to pain therapy. However, one COMMENTARY Professor Flaminia Coluzzi Medicine and Pharmacy Faculty, SAPIENZA University, Rome, Italy Although the need for improved therapy for pain has been recognised by the Italian autho- rities for some time, legislative changes have been only slowly implemented. The instigation of the CHANGE PAIN® program is now bringing benefits to Italy through the improved education of healthcare profes- sionals involved in pain management. We anticipate that this improve- ment will soon be reflected in the more effective treatment of chronic pain patients throughout the country. Professor Flaminia Coluzzi EXPERIENCE IN ITALY IMPLEMENTATION OF THE CHANGE PAIN® INITIATIVE PATIENT TREATMENT DAYS OF STRONG OPIOIDS IN EUROPE IN 2009 180 160 140 120 100 80 60 40 20 0 Germany UK France Spain Italy 173.7 118.3 60.0 52.9 21.4 Fentanyl Patch Buprenorphine Patch Hydromorphone Oxycodone Morphine