By Margaret Aranda, MD, Columnist
Patients go to doctors when they have pain and doctors can give them opioid medication to relieve that pain. That should not bother you, because it is a decision made between the physician and the patient.
No doctor has the right to strip a patient of dignity by minimizing or downplaying their pain. We can’t become indifferent to the denial of pain, because pain is real. Pain hurts.
A recent column in The Conversation by Dr. Andrew Kolodny bothers me because of two sentences:
“They (opioids) are also helpful when used for a couple of days after major surgery or a serious accident. Unfortunately, the bulk of the opioid prescriptions in the U.S. are for common conditions, like back pain,” wrote Kolodny, who is a psychiatrist, not a pain management doctor.
Let’s look at the different ways that Dr. Kolodny is minimizing pain:
Postoperative Pain: A large study recently found that long-term opioid use after surgery is rare. Yet some patients are now being denied opioids after major surgery because of fears they might become addicted. Patients should ask questions about how their postop pain will be treated before surgery and get another surgeon if no opioids are to be offered. Patients do not have to allow a surgeon to minimize their pain.
Trauma: Serious accidents cause severe trauma. Severe trauma can take months, years or decades to alleviate, leaving patients with chronic pain through no fault of their own. Many are burned, disfigured, scarred, disabled, have a pain syndrome, use a wheelchair, and go on disability or Medicare.
We cannot allow ourselves to minimize any degree of pain that leads to suffering, less zest for living, and lower quality of life.
Back Pain: Millions of people have low back pain and the added mental health stress that often comes with it, which costs the U.S. economy $100-200 billion in lost workdays and productivity annually. Don’t minimize their pain, either!
Treating Pain: No doctor who witnesses a patient suffering in an emergency room, operating room or intensive care unit should minimize their pain. I’ve worked in all three as a board certified anesthesiologist and intensive care unit doctor, and am a witness to how an Ivy League university, private clinic, free clinic, county hospital, women’s hospital, and Veterans Administration hospitals treat severe pain that may never, ever get better. I’m also a witness as a rebel patient who was offered acetaminophen and ibuprofen for my postop pain.
Physician judgment: Many patients with chronic pain are disabled and legally protected from discrimination. They have failed other therapies and deserve opioid medication for quality of life. They are not…