Wednesday, January 11, 2006

In the news: "Let's Get Serious About Relieving Chronic Pain"

Jane Brody had a great article in the NYT about how the federal government is making it harder for patients to get relief from chronic pain:
In addition to a case before the United States Supreme Court, Gonzales v. Oregon, that threatens to undermine Oregon's Death With Dignity Act, the D.E.A. has recently increased raids on doctors' offices, confiscating files and arresting doctors on charges of overprescribing narcotics to patients who are addicts or drug dealers. Most of these physicians are compassionate people trying to help suffering patients but are sometimes fooled by clever addicts, drug dealers or undercover agents who fake their pain.

Should the court rule against Oregon, the D.E.A. could turn to all physicians whose patients die while getting prescribed opioids or barbiturates, even if the drugs were administered only to relieve intractable pain, not to hasten death. Yes, there are bad apples among members of the medical profession. There are some doctors who charge for medical exams that they never do and provide phony patients with prescriptions for narcotics to feed their habits or sell on the street. But should all physicians be subject to intense scrutiny by the D.E.A. and risk arrest and prosecution, leaving legitimate patients to suffer intensely or scramble to find other doctors willing to risk taking them on?

If the government caused this kind of interference with, say, cancer drugs or birth control, there would be a huge outcry. But the public doesn't regard pain relief as being quite as serious an issue as cancer therapy or contraception. Pain, after all, is not life-threatening. The problem is that people who have not experienced chronic pain understand only temporary pain, and chronic pain does not equal a permanent headache. Chronic pain is not just temporary pain extended through time. It's qualitatively different- it reaches beyond the physical experience of the pain and wraps its tentacles around your marriage, your friendships, your job, everything.

Can we please get rid of our cultural baggage about the nobility of suffering, can we formulate a drug policy that's not influenced by the veneration of the suffering Christ on the cross?
Link (free reg req'd)

3 comments:

Beth said...

Good stuff (although I'm not sure what the last line has to do with it). I think there needs to be better understanding of what chronic pain is. That there are biological differences between people on pain threshold, response to opiods etc.- it's even present in lab rats who we don't typically label as being "wimpy". Good point how it isn't a hot button issue like birth control etc. The lack of understanding with chronic pain is similar to the stigma put on those with psychological illness- like they should just "get over it" when people would never dream of telling a person with cancer to "just get over it".

I think med schools are starting to get with it- but it will take a while for the newer outlooks on pain management to trickle down to dr.s that are practicing and the general public.

Stephen said...

Curioius that the Fed Gov't should make it harder for people to get pain meds,since the Fed Gov't is the cause of so much pain.

Cutter said...

"Can we please get rid of our cultural baggage about the nobility of suffering, can we formulate a drug policy that's not influenced by the veneration of the suffering Christ on the cross?"

This is something to chew on for a while. Thanks.