Pain management in this country has taken a giant leap backwards, taking on a medieval, draconian mindset.
15-20 years ago there was a movement in the medical community to treat pain as the 5th vital sign. "Pain is what the pt says it is" was in all the nursing education annual competencies, and it was used as a subjective pt assessment tool. MS Contin had been around for years before this, and this long acting pain medication seemed to be used without any untoward societal consequences, as there were no daily news stories of abuse and death that I can recall back then when I was a new nurse. Then oxycontin was created as another adjunctive tool to ease the suffering, and increase the quality of life for of millions of chronic pain pt's. Before long a glut of news stories began to surface - reporting waves of crime, substance abuse, and death - hitting the daily news like a hail storm.
What lead to this? Did oxycontin itself act as the catalyst that created this epidemic? That is certainly what I've surmised from the countless articles I've read on the subject over the years. But is this true? Did oxycontin create a hoard of mindless, slavering drug addicts - who'd sell their mother for a fix - from once previously pious, everyday people?
Suddenly chronic pain pt's - all chronic pain pt's - were under scrutiny, and became objects of suspicion. It became a shameful thing to suffer from chronic pain and take routine Rx pain medication to offset the agony.
Seemingly over night the view point regarding chronic pain did a 180Â° turnabout, leaving countless genuine pain sufferers in the lurch.
Rx narcotic regulations changed, stating acute pain in some states could only be treated up to a 72 hr limit, and postoperative surgical pain for up to 7 days. Chronic pain is more difficult to receive proper treatment for now than ever. And if you actually have chronic pain you better be able to prove it beyond a shadow of a doubt.
What if you, or one of your loved one's suffered chronic severe pain? What then?
Those whom have abused narcotics, and those whom have abused and died from overdoses, have become the new poster children for the face of chronic pain. Due to the internet, news stories are able to be all around the world in a matter of hours, sensationalizing it even further.
Long before the oxycontin news stories became a dime a dozen, there were still people who abused and misused - oxycontin didn't create these behaviors. And I'd like to point out those whom will abuse Rx narcotics will likely abuse any substance: ETOH, street drugs, illegally obtained Rx narcotics, cigarettes, aerosol chemicals, bath salts â€¦ the list goes on and on.
What does this mean for those folks whom genuinely have a moderate-severe to severe chronic pain problem? They are SOL now, because those who've never experienced intractable, unremitting chronic pain have bundled them all together into one giant group and now treat them all the same.
Many provider's attitudes toward pain is: "Pain hurts, and it is to be endured". There are people who literally cannot imagine what it is like to experience pain that never gets better or goes away. Pain that takes your breath away â€¦ pain that makes you cry. Most people's experiences with pain are acute situations that usually get better over time, move toward resolution, and eventually is gone for good. If you're lucky that is.
Of course there are people who abuse narcotics - we've all meet them in the course of our career - or even in our private lives, however there are also those people who do not. Those that use their Rx meds exactly as Rx'd, who've stayed at the same dose well managed for years, who don't ask for early refills, don't come up with ridiculous stories that their Rx was stolen/lost/accidentally thrown out, don't ask for higher doses, don't have other illicit substances in their urine, don't doctor shop, don't visit the ER's, whom use the same pharmacy every time, and tough out their acute pain flairs at home quietly.
My mother was that person before she died.
Those people don't deserve to suffer as a group unfairly because of other people's actions. Each pt needs to be treated on a case by case basis. This does take time and energy - but what's the alternative? Condemning people to endure a lifetime of suffering that could otherwise be alleviated? I agree with the OP - this set's some pain sufferers up for suicide risk. I can think if at least 3 pt's in the past 22 years of my nursing career that were medically mismanaged and couldn't stand the constant severe pain a minute longer, taking matters into their own hands to do just that.
I feel so very lucky my mother's pain was well managed, and she didn't live to experience the current totalitarian cultural climate of chronic pain pt's always being under suspicion. To see her suffer would have broken my heart.
The Rx pain meds she took enhanced the quality of her life, and she told me many times that she would rather die than suffer though the pain she had underneath, that which the Rx pain meds blurred and softened around the edges, but never took entirely away.
And I believed her too.