Stefan Kertesz is a primary care doctor and a researcher on drug abuse. In this commentary, he shares how decisions about prescribing opioids come from delicate and deliberate conversations between doctors, nurses and patients.
Several new federal initiatives focus on getting doctors to rethink opioids for pain, including a new guideline from the CDC.
Now, yes, an educational word of caution is needed. There are some egregious prescribers who practically throw prescriptions at patients. And then there are many who seem to miss the realities of the people they are writing those prescriptions for.
For patients in pain, I urge treatments that don’t involve pills.
But I also worry that guidelines focused solely on our prescription pad fail to address the sensitive realities of pain care.
In one study, the average doctor seeing a patient with pain had 6 minutes to discuss it. What will we do differently in those 6 minutes after reading the CDC’s 52-page guideline?
If all we talk about is a pill, for or against, we are having the wrong conversation. We don’t take care of prescription pads. We take care of people.
New guidelines might help a little. They would help a lot if they came with commitments to assure more time for us to care for patients, and better access to specialists in addiction and pain.
Those commitments have not been forthcoming. I’m sure we can bring opioid subscribing down since it is already coming down, but to make this change humanely we need to focus on people, not just pills.