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DonViejo

(60,536 posts)
Mon Nov 27, 2017, 02:11 PM Nov 2017

Should Doctors Treat Pain? Surgeon-General Isn't Sure

BY DAVID BOAZ ON 11/27/17 AT 11:45 AM

The rising level of deaths from opioid overdoses is getting a lot of attention, including from a Nobel laureate economist and the White House.

In the rush to find a solution to the problem of opioids, I hope we don’t forget the problem that opioids were intended to cure: chronic severe pain.

Living with that kind of pain is awful, and it’s wonderful that science has found ways to help people in pain. But that’s not the way President Trump’s surgeon general sees it. In an NPR interview last week, Dr. Jerome Adams had this to say:

NPR’s Elise Hu: Much of this crisis started in doctors’ offices. We’ve heard statistics like doctors in the United States prescribe four times the number of pills per person that doctors in the United Kingdom do, for example.

What do you think is encouraging doctors to prescribe at those levels?

Dr. Adams: Well, I can tell you, as one of those doctors, that many of my colleagues tell me they feel pressured to prescribe. You have patients who expect an opioid is the only or main way to treat their pain.

But I would take issue with one thing you said—I don’t think it started in the doctors’ offices. I think it starts before that. I think that it starts with this expectation that everyone’s going to have no pain, with the idea that a pill can solve everything.

And we need to help folks understand there’s a real danger to feeling like we can medicate our way out of any and all problems.

(Note: that statement appears at about 4:25 in the audio, but not in the related transcript.


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http://www.newsweek.com/should-doctors-treat-pain-surgeon-general-isnt-sure-723341
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Should Doctors Treat Pain? Surgeon-General Isn't Sure (Original Post) DonViejo Nov 2017 OP
The Suck it Up, Cupcake treatment for chronic pain. kcr Nov 2017 #1
The ACA would have helped ghostsinthemachine Nov 2017 #2
Maybe if insurance companies would cover xmas74 Nov 2017 #3
People with chronic severe pain issues are likely MineralMan Nov 2017 #4
Idiocy Orrex Nov 2017 #5
Work continues on agonists of the κ-opioid receptor that only provide pain relief FarCenter Nov 2017 #6
I hope he gets intractable chronic pain. Lars39 Nov 2017 #7

kcr

(15,318 posts)
1. The Suck it Up, Cupcake treatment for chronic pain.
Mon Nov 27, 2017, 02:14 PM
Nov 2017

That's what chronic pain sufferers can expect until it shifts the other way again after this panic is over. If it ever does.

ghostsinthemachine

(3,569 posts)
2. The ACA would have helped
Mon Nov 27, 2017, 02:33 PM
Nov 2017

By people keeping their scripts instead of looking for relief on the street.

I could not imagine life without opioids. For the first time j. Four years, I increased frequency and dosages by 1/3. New. Leg problem, unrelated to my esophageal cancer. I hope we get that together, via therapy, so I can go back to my usual. My hands and RMS, that's forever.

xmas74

(29,674 posts)
3. Maybe if insurance companies would cover
Mon Nov 27, 2017, 02:39 PM
Nov 2017

Treatment besides prescriptions we'd be in a better place with some patients. Some could possibly have additional surgeries, therapies, etc and eventually be weaned off in an in patient monitored setting. Some can never be weaned and some have no other options.

There's a real danger in blaming the patient. It's disturbing and frankly disgusting. This is not how a surgeon general should approach a problem.

MineralMan

(146,321 posts)
4. People with chronic severe pain issues are likely
Mon Nov 27, 2017, 02:49 PM
Nov 2017

to have problems with getting prescriptions before long. I fully expect an official push to wean everyone off opioids to begin very soon. And that push will come from lawmakers who do NOT have chronic, severe pain. They'll try to make it more and more difficult for doctors to prescribe the drugs by requiring costly paperwork, and require all sorts of red tape for pharmacies, as well. Prices, too, will probably go up, under the belief that people won't buy the medications if they're too expensive.

That's how lawmakers try to solve problems. They don't look for actual solutions, but for ways to get the issue off their plates. The consequences don't matter to them.

People with plenty of money will have no problem getting their opioids. It will be those who have financial issues, along with their chronic, unremitting pain who will end up being unable to get relief. Worse, that kind of pain makes it very, very difficult to continue to earn money. It's a lose-lose proposition for many people.

I expect things to get very difficult and quite soon. It will be a terrible time for many people. We should fight any measures that restrict opioid medications prescribed by physicians for pain. If we do not, the very people who need them the most will be left to suffer.

Orrex

(63,219 posts)
5. Idiocy
Mon Nov 27, 2017, 03:19 PM
Nov 2017

When I had dental work done, I got a script for 30 Oxycodone. I took one.

When I went to the ER for an abscessed tooth, I was given a supply of 30 Oxycodone. I took one.

When I had an ingrown nail corrected, I got a script for 30 Oxycodone. I took none.

So that's 88 Oxy more than I needed.


I suspect that the main problem is not chronic pain suffers receiving treatment for their condition, but rather the over-prescription of opioids for people frankly don't need anywhere near that many.

 

FarCenter

(19,429 posts)
6. Work continues on agonists of the κ-opioid receptor that only provide pain relief
Mon Nov 27, 2017, 03:24 PM
Nov 2017

Drugs can be structured to stimulate the pain relief pathway, but not the respiration suppression pathway. They are therefore safer, since most addiction deaths occur when breathing stops.

It is still unclear whether they will be less addictive, but there is some indication of that in animal experiments.

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