Chronic pain and chronic pain medications

Pain is a very subjective thing. What one person feels is a 10 over 10 another person might rate as a 1 over 10. For example, a navy seal might consider a broken bone not too bad while many people might rate it as severe. There is no quantitative test to determine pain and for pain doctors that makes our job tough. We have to be the policemen of the pain medications. We have to determine who is appropriate and who is not for these medications. Obviously, we evaluate the patient, regularly exam them but we still rely on the patient to give us information about how they feel. When I see patients who have had multiple spinal surgeries and they are suffering with residual pain I feel the need to help them with their pain. It gets harder when their pain is more subjective in nature. Nonetheless, we try to take the patient at face value until we have reason to believe otherwise. The unfortunate thing is that there are a lot of people who want to waste their lives away doped up. As a physician who loves to be on the “top of his game”, I can’t understand how people can want to be obvious to the world around them. This makes it hard for us pain physicians since we want to help those who truly need the help whilst eliminate those trying to fraud the system. Luckily, it is rare that someone can play the system for long without getting caught. They may get away with it for a little while but they usually get caught. We in the healthcare community do care about those suffering but we have to monitor the usage of controlled substances. Too many people die each year from chronic narcotic usage and the abuse in this country is severe. there are times I wish these medications were legal so that people who really needed my help would be the only ones who knocked on my door but alas that isn’t the case. Just as 90% of the people who use “medicinal marijuana” really are just using it to get high, a certain number of the people who utilize pain medications also are lookin to just abuse them. This makes it very hard for those truly suffering from chronic pain. I guess we will have to keep trying to help patients until they make us believe that they are abusing the pills. Quite a dilemma and no wonder so many doctors are just saying no to chronic pain patients.

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