Pain Management: Conspiracy to Addict Everyone?
Controlling pain has always been a primary goal of clinicians. It is my conviction that the discovery of Ether was the single most important discover in medicine (closely followed by the germ theory and antisepsis theory). Getting control of chronic pain continues to be a major conundrum.
About 20 years ago, a Harvard researcher published a series of articles on the problem of pain. In particular, control of pain in the post operative patient. His conclusions led to a much greater awareness of our inadequate use of pain medicines in patients following surgery. These conclusions were extrapolated to chronic out patient care — a crucial mistake in logic. That scientist and recently apologized for his research. Why? because his conclusions were used by self interested individuals to justify the over prescription of higher and higher doses of narcotic pain medicines. Now we have a major epidemic of pain medicines — leading to severe side effects, up to and including death.
Over that time, doctors and nurses had to take extra, mandated, courses on pain management. The only bullet points that I could get from those conferences were: 1. Don’t under-treat, or you can be sued. 2. Don’t give too much, or you will lose your license. This left us with a very narrow corridor of treatment options. Referrals to pain specialists soared.
**IMPRESSIONS AND RECOMMENDATIONS: **
- Chronic pain is a tough problem to treat. We are in need of better solutions.
- Narcotics are a rarely the best option, use only when nothing works.
- Living with a little pain is better than the side effects from Narcotics
- Anyone can get addicted, given enough time and doses (do not believe that some humans are immuned to addiction — those individuals are rare or non existent).
- As I have stated before, be skeptical of research that may be tied to the pharmacy or food industry. Those studies need extra evaluation and analysis before meaningful conclusions can be made.