The first time I had an appointment with my orthopod there was a whole sheaf of papers to read and fill out and sign. One document asked the patient to sign that they (me) understood that their office would not prescribe pain medication for longer than three months. After that, if the patient had unrelenting pain they would be referred to a pain management clinic for treatment. This applied to both medically managed patients as well as surgical patients.
Wow, I thought, that sounds a bit harsh. I was not on any pain medication so wasn't thinking about myself. That's not to say I wouldn't have taken a pain pill for my shoulder pain. They just didn't help at all so it was not an issue with me. But I know of lots of folks with orthopedic pain who might want some pain pills longer than that. I didn't understand the problem.
According to an article in the New England Journal of Medicine, prescription drug abuse is a big problem. In 2012 clinicians wrote about 259 million prescriptions for opioids, enough for every American to have one bottle. And to make it sound even worse, opioid use declined from 2009 thru 2010 when it rose again.
According to the Center for Disease Control, narcotic painkiller sales rose 300% between 1999 and 2008. In 2010 prescription overdoses with opioids resulted in 100,000 emergency room visits. Two thirds of ER visits for overdoses were for prescription overdoses. Increased opiate drug sales matched an increase in theft and abuse.
So that explains why physicians are reluctant to write an RX for pain medication. But solving the drug problem is not that simple.
Unfortunately, as the prescribing of opiate pain medication went down, there was an increase in heroin abuse and illegal drug overdoses. As ordinary middle class people find they are unable to acquire pain meds legally, some turn to seeking out illegal sources of heroin. Adam Bisaga, MD, an addiction specialist in New York reports, " the solution to addiction must involve treatment rather than just simply trying to restrict legal access...You see drug cartels expanding into smaller towns. Heroin is reaching rural areas where it was never seen before."
Hopefully pain management clinics are waging war against drug addiction on two fronts, reducing opiate RXs and getting addicted patients into treatment. This certainly gives me a better understanding of the difficult position a physician is in.
Wow, I thought, that sounds a bit harsh. I was not on any pain medication so wasn't thinking about myself. That's not to say I wouldn't have taken a pain pill for my shoulder pain. They just didn't help at all so it was not an issue with me. But I know of lots of folks with orthopedic pain who might want some pain pills longer than that. I didn't understand the problem.
According to an article in the New England Journal of Medicine, prescription drug abuse is a big problem. In 2012 clinicians wrote about 259 million prescriptions for opioids, enough for every American to have one bottle. And to make it sound even worse, opioid use declined from 2009 thru 2010 when it rose again.
According to the Center for Disease Control, narcotic painkiller sales rose 300% between 1999 and 2008. In 2010 prescription overdoses with opioids resulted in 100,000 emergency room visits. Two thirds of ER visits for overdoses were for prescription overdoses. Increased opiate drug sales matched an increase in theft and abuse.
So that explains why physicians are reluctant to write an RX for pain medication. But solving the drug problem is not that simple.
Unfortunately, as the prescribing of opiate pain medication went down, there was an increase in heroin abuse and illegal drug overdoses. As ordinary middle class people find they are unable to acquire pain meds legally, some turn to seeking out illegal sources of heroin. Adam Bisaga, MD, an addiction specialist in New York reports, " the solution to addiction must involve treatment rather than just simply trying to restrict legal access...You see drug cartels expanding into smaller towns. Heroin is reaching rural areas where it was never seen before."
Hopefully pain management clinics are waging war against drug addiction on two fronts, reducing opiate RXs and getting addicted patients into treatment. This certainly gives me a better understanding of the difficult position a physician is in.
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