A short opinion piece on the dilemma of today’s pain patients: The big thing Congress can’t do to fix the opioid epidemic
A quote: “This, I think, is the hardest part of backing away from opioids: Admitting that medicine doesn’t have a perfect cure for pain— that for some patients, zero pain isn’t possible.”
Sad but true. A response from one pain patient: “Yeah, well, eff that, buddy.”
Can’t blame him, can we? The pain’s not his fault. The fact that it’s chronic, not related to any clear current physical cause– that’s not his fault either. It’s probably the result of something gone haywire in the nervous system. And in most cases, it can’t be remedied through surgery.
Opioids were a godsend for quite a while, but perhaps something changed. In fact, they may now be a major factor in the continuing pain. The cure worse than the disease?
The article notes the author’s surprise at reading about how physicians supplied patients, mostly war vets, with copious quantities of morphine in the latter half of the 1800’s. When the public began to worry about the addictive propensities of morphine, doctors transitioned the patients to a new and improved option– heroin. Maybe not the best idea. But the most expedient.
Physicians have never been all that shy about maintenance opioids for chronic pain. Many of today’s docs are perfectly fine with the notion. So it shouldn’t come as a complete surprise that the healthcare professions were eager to adopt the new paradigm of pain as the Fifth Vital Sign, necessitating ever greater reliance on drugs like Oxycontin.
Although I have observed that when a patient began to exhibit signs of loss of control– taking too much, begging for frequent refills, supplementing with street opioids– those same physicians could be mighty quick to cut that patient loose. On what grounds? He or she was “abusing” medication.
We did our job, the physician would argue. The patient didn’t.
As the article suggests, we still don’t have a genuinely good treatment for many victims of chronic pain. In the past, we’ve flung opioids at the problem, and haven’t developed alternatives. Our bad.
Maybe now, in the midst of this awful epidemic, we’ll get serious about finding some.
— October 18, 2018 @ 
