Denying Pain Patients Relief is Not an Answer

This is a tough time to be a chronic pain patient. But it’s equally difficult for their doctors. The pendulum, which had swung too far in the direction of opioid prescriptions for simple dental procedures and minor ailments, has swung back, also too far, in the opposite direction.

As the pharmaceutical executives and their marketing methods have come under public and legal scrutiny, all pain patients have been re-branded as opium addicts or opium dependent, despite the fact that it’s been understood for a long time that pain is the “fifth vital sign,” which means it conveys something about a patient’s condition that a doctor needs to know to design an appropriate treatment plan. Because  it became a symptom that was starting to be abused, now all chronic pain patients are tarred with the same brush.

Among doctors who see patients with chronic pain, it is understood that not all patients are the same. In our current climate, the opiate crisis has made it very difficult for pain patients to get the medication they need in order to function as productive members of society. Some of these patients have been on opioids for decades without abusing them or becoming addicted.

These people are extremely stable and monitored regularly. But with the current scare tactics that have affected the physician community, including our practice, some of these patients have been unable to get the medications they need in order to continue to take care of their families. These are not jobless midwesterners living under a bridge, they are business people and professionals, mothers and teachers. Lumping them all into one pot is ridiculous.

As an interventional pain management specialist, I believe in treating each patient as an individual and understanding the true reasons for their pain. I have received special education for this, and we don’t just hand out opiates on the street. We monitor every patient that receives any kind of treatment from us, both for safety and for efficacy.

Believe me, opiates are not the first treatment modality we use — instead it’s closer to the last. Physicians are aware of its side effects. We are a practice that believes in “first do no harm,” and that’s why we also offer simpler remedies like CBD. Because we have a large practice, we’ve already gotten some notoriety for the number of prescriptions we had written. But how about looking at the number of patients we serve?

The biggest issue for pain medicine specialists is how we are going to continue to treat our chronic pain patients.  If we are not going to be allowed to take care of our chronic pain patients appropriately through well trained physicians in the medical system, these patients — many of whom have had these same signs and symptoms for decades, will find other, more dangerous ways to seek help. That would be a bigger contributor to the opioid crisis than what is currently happening.

It has been reported over and over again that kids get access to their parents’ prescriptions, get addicted to opiates, and then turn to heroin. If this is true, the responsibility lies with the parent who leaves these medications around the house, and with the physician who doesn’t educate his patients on the danger of their falling into other hands. Better patient education, such as teaching parents to return pills they don’t take to the office or flushing them down the toilet would work better than politicizing this serious issue and over-reacting as a society as we are currently doing.

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