Originally Posted by
David Kirkham
I find this entire discussion fascinating. A special thanks to everyone who has participated--especially the docs. Again, I am quite sympathetic to anyone who is in chronic, serious pain. It just plain sucks. It takes over your life. It's horrible.
I'll just throw this in. I have a customer who is the head of a very large ER department in a major city. We got into this whole opioid discussion one day and I commented, "I was very surprised in the hospital when, right after the birth of one of our children, the hospital gave my wife 800 mg pills of ibuprofen for pain. Why not an opiate?" My customer replied, "There is very little pain I can't control with an appropriate dose of ibuprofen and I see a lot of bad stuff. It is my main, go-to medicine of choice. It is cheap, safe, and incredibly effective."
We did discuss the terrible problem of addiction and he said, "You have to really be obviously hurting--like a bone sticking out--before I reach for the opioids." (I don't know if that was just his frustration speaking--but clearly there is a major problem). He says patients get mad and give him bad reviews, but the hospital can't really do much about it because he is the Department Head, about to retire, and the hospital is ground zero in a very bad neighborhood where no one else wants the job. He says people ask him "all day, every day" for pain pills.
Contrast that to another customer who is the head of the ER in another major hospital, "The stupid legislature has mandated that we control pain. Patients come in here and threaten to give us a bad review if we don't pass out pills...so we pass them out. We are creating addicts right and left to not get written up and have our jobs threatened. It makes me sick. This isn't why I went into medicine."
Clearly we have a problem. One of the reasons I am so interested in this is I have the ear of many legislators in our state. We discuss this very topic ALL THE TIME. It is taking up a disproportionate amount of their time, money, and energy.