Many people become addicted to pain pills—and sometimes end up on heroin—because of simple prescription drug misuse. Primary care physicians prescribe medication for all kinds of ailments, and if a patient comes to the office with a complaint of pain from an injury, or if the person suffers from a debilitating condition, they often feel it is well within their scope of practice to choose the appropriate medication without referring the person elsewhere.
In the meantime, this country is in the middle of a full-blown epidemic of opiate and opioid addiction stemming from prescription drug misuse. The pharmaceutical companies worked double-time a decade ago to implant in physicians’ minds that opioid medications were well suited to treat pain of any level, whereas many years ago opioid medications were reserved for people suffering from terminal illnesses. As a whole physician professional organizations do their best to correct the misinformation that’s out there.
Uneasiness Among Physicians
Yet there has always been reluctance among physicians to deny relief to their patients in pain. The AMA cites a 2011 Institute of medicine report indicating that 100 million Americans live with chronic pain. Families of patients in pain also urge physicians to provide relief to those suffering. Even law enforcement officials have testified in malpractice cases against physicians who have withheld opiates to treat pain, worrying about prescription drug misuse. However, the constable whose testimony came to this writer’s attention declined to be interviewed.
A website called Common Sense for Drug Policy five years ago excerpted an interview of a Johns Hopkins physician who stated that “removing pain medication from the market was not the answer to our epidemic,” and in fact he thought “painkiller addiction was blown out of proportion.” Half a decade later, this physician knows he was so wrong about prescription drug misuse, and he now advocates for other ways to manage pain.
The Reporter-Times of Martinsville and Morgan Counties, Indiana, posted a piece just this month including commentary by Dr. Melanie Rosenblatt, admitting that physicians feel awkward discussing pain with their patients. You go into the doctor’s office prepared to talk about what’s bothering you, this piece begins, but your questions disappear when the doctor walks in. So what’s up with that?
Prescription Drug Misuse Taken Too Far
The truth is that people who suspect they have gone too far with prescription drug misuse feel uncomfortable admitting it. In the hurried, harried office visit common in today’s medical climate, we are rushed in and out of the office. In a survey conducted by Teva Pharmaceuticals in collaboration with the American Academy of Pain Management and the U.S. Pain Foundation, 40 percent of doctors admitted that conversations with their patients about pain make them feel uncomfortable, and 29 percent of people interviewed who are affected by daily pain believe that any complaint of pain will be viewed as pill-seeking behavior.
Three-quarters of physicians interviewed and 71 percent of the patients—a statistically similar number—agree that education about pain management is the best step toward effective pain relief without risking prescription drug misuse. Yet, at the local levels, pain management physicians and addiction treatment specialists still are not working in tandem. When a medical office manager recently referred a patient to a local pain clinic, the scheduling receptioni
st’s immediate response to the referral was, “You do know we’ll be giving him pain pills, right?” This said, before the patient had even been seen at the clinic.
It’s easy to fall into that attitude, however, because many people do in fact perpetuate their prescription drug misuse. The director of a TASC program reported a client referred by the courts who insisted at his assessment that he needed the pain pills he took every day and that they were prescribed by his doctor. When the staff took the next step and requested the physician’s records, the physician reported that he had not seen the patient in almost a year and he felt the patient was misusing prescription drugs—and also that he had not prescribed for this patient over the past six months.
So, there are indeed ways to manage pain without falling into opiate addiction through prescription drug misuse. Methadone treatment programs can help the client who wants to overcome his addiction as long as that person is willing to sit down and have an open and honest conversation with the doctor about pain management. Substance abuse treatment professionals understand that real pain cannot remain part of a person’s life if they’re going to change their life. Why not contact your local methadone treatment program and get that conversation started?
