This document, which I found on a hospital website and annotated below, is a leftover from the “good old days” when doctors were actually obliged to provide effective pain care (and even too much in too many cases).
In the 1990’s, a lot of effort and money was spent trying to convince the public that opioids were safe if used responsibly for legitimate pain control – which they truly are, of course. Or they were before 2000, when the pendulum started heading back to the demonization of all opioids.
All the money spent publicizing and advocating for the use of opioids for proper pain control before 2000 is dwarfed by the amounts now being spent to demonize those very same opioids. Compassion for people with chronic pain evaporated. Suddenly we became lazy and self-indulgent addicts, and we were shunned.
All the latest uproar over opioids has little to do with science or even facts; that was proven beyond any doubt by the biased and scientifically inaccurate CDC Guidelines.
They say this is just a swing of the “pendulum”, as though this were a justification, without thinking of the implied cruelty, allowing the quality of our lives to hang from such a fickle instrument of social whims.
This prohibition pendulum swings with the flow of money and has little to do with the actual welfare of citizens. It’s powered by what I’d call “special interest” money, but there’s nothing special about an avid interest in money, no matter what guise it operates under: hospital program, drug-testing lab, addiction-recovery center, pain clinic, or “alternative medicine”.
These pain/addiction “treatment centers” have tremendous profit potential. Most are not even regulated nor scientifically proven effective, so new businesses are springing up and investors are rushing to take advantage of the situation.
Organizations will go so far as to give themselves misleading names, like “Famous Pain Clinic”, when their real aim is only to relieve us of our “drug dependence”. Addiction recovery is all the rage these days, whether needed or not.
If we wait long enough (should we live that long – or want to live that long) this pendulum will undoubtedly swing back again. I understand this logically, but with so much at stake for me personally, it doesn’t seem possible – certainly not in my lifetime.
Misconceptions about chronic pain can do harm to people with legitimate medical problems. P
atients with chronic pain can and should be treated. Dispelling these damaging myths should raise awareness and encourage more people to seek help with a professional trained in treating chronic pain.
Myth #1: If the doctor can’t find anything wrong medically with a patient with chronic pain, it must be “in their head.” Maybe they’re crazy.
Fact: Chronic pain is not “in your head.” It is a legitimate medical condition that can and should be treated. Unfortunately, the exact cause of chronic pain cannot always be found. Pain is a complex personal experience, and not all doctors have received adequate training to treat it. Pain management specialists are specifically trained to recognize and treat common and unusual conditions that cause ongoing pain. Although not all pain has an identifiable cause, there is an effective treatment for most painful conditions.
Myth #2: If people seek treatment or complain about their pain, it means they’re weak.
Fact: Seeking treatment has nothing to do with being weak. Many people with chronic pain feel trapped and helpless, and do not want to burden anyone else with their problem. It is important for them to realize that there is no need to suffer because effective treatments are available.
Myth #3: People who take powerful opiate (“narcotic”) pain medication become drug addicts.
Fact: Opiates are highly effective for many types of pain and can be given safely. Physical dependence from pain relievers is different from addiction. Drug addiction is characterized by compulsive craving and use of a drug, which results in physical, psychological, and social harm to the user. An addict’s drug use continues in spite of predictable, consistent harm (self-destructive behavior.) The vast majority of people taking opiate medications for pain management do NOT become addicted. Drug dependence, where the body becomes used to the presence of a drug, can occur with the prolonged use of some pain relievers.
Myth #4: The side effects of opiate painkillers turn people into zombies and can stop their breathing.
Fact: Most side effects are mild, tolerable, treatable, occur at the beginning of therapy, and fade with time. Common side effects include constipation, drowsiness, and dry mouth. Careful adjustment of dosages and attention to patient concerns help alleviate most side effects.
Myth #5: People with chronic pain treated with opiate pain medications will have to take more and more medication as time goes by to get the same pain relief (tolerance).
Fact: Most patients have stable dosages with time. Increases in medication dosage usually result from worsening physical or psychological status.
Myth #6: Some people don’t want to get better because they benefit from being in pain.
Fact: Most people don’t enjoy being in pain. Research shows that exaggerating about pain and malingering are actually rare. Assistance from others when pain limits activities or financial compensation for a work-related injury is appropriate for people who suffer from chronic pain.
Myth #7: Ignoring the pain will make it go away.
Fact: In most cases, ignoring ongoing pain will not make it go away, and it may even get worse. It is better to seek help from a caring, experienced specialist when pain persists and becomes a problem.
Myth #8: People should try to overcome their pain by pushing themselves to do things.
Fact: Knowing one’s limits and pacing oneself can help people manage their pain. Overdoing it and pushing too hard can exacerbate pain.
Myth #9: If someone looks good, they can’t be in pain.
Fact: Many people with chronic pain go about their business and do as much as they can, in spite of their pain. There are no outward signs of chronic pain (unlike acute pain). Just because people look comfortable does not mean they are not in pain. This misunderstanding creates much emotional distress for people with chronic pain.
Myth #10: Many people have been to several doctors, but haven’t been helped. They’ve been suffering from chronic pain for so long, they’ll just have to live with it.
Fact: With few exceptions, there is no need for anybody to live with unbearable pain. A variety of treatment options are available, but it is important to find the right doctor. Just as people see a cardiologist for heart disease or an ophthalmologist for an eye ailment, pain management specialists are trained to treat chronic pain. Patients should make sure they see a qualified pain specialist to get the treatment they need. Pain management specialists will listen carefully to the history, perform a thorough physical examination, and may refer a patient for other tests or medical consultations before coming up with a comprehensive plan for care.