Should We Believe Patients With Pain? – Nov 2018 – by Cmdr John Burke
I recently came across an article about the symptoms that patients with fibromyalgia suffer and the likelihood of their committing suicide.
The rate of suicide is potentially very high, and the prospect of someone we know and love suffering from this disease and considering this drastic action seems plausible.
I have a very close family member and a good friend who both suffer from this disease. The associated pain has been described as excruciating, and they pray that the symptoms pass quickly, meaning in a few days, not hours.
Years ago, I suffered from cluster headaches, which have been described as “suicide headaches” because their intensity is incredible, and the pain I felt far outweighed any other that I have ever experienced.
Fortunately, these cluster headaches stopped when I was in my 50s, but some are besieged by these headaches multiple times a day for weeks on end.
I cannot say that if my cluster headaches had continued that I would not have been tempted to take drastic action.
This brings me to my mother-in-law, who passed away several years ago after experiencing 70-plus years of chronic pain. She had moved in with us, and I found out that her former physician, who had died several decades prior, told her never to take anything stronger than aspirin, or she would become addicted.
This borders on malpractice. It’s like telling AIDS patient that they shouldn’t take the life-saving retroviral medicines because they “aren’t good for you” (they aren’t).
Almost all medications have some negative effects, no matter how much they are needed (think about chemotherapy), so this cannot be the sole criteria for their use.
So, trusting her doctor, she never did take anything stronger or even ask a practitioner for pain medication. This lady had her legs fused together when she was in her 20s and later refused to allow physicians to amputate them, even though the pain had become almost unbearable.
Once I found this out, we sent her to a doctor who I thought would prescribe an opioid to give her a chance to live a somewhat normal life.
Unfortunately, that physician lied to my mother-in-law, saying she could not prescribe pain medication.
I hear about so many doctors are telling patients they “cannot” prescribe opioids, that it’s “illegal”, and I’m glad to hear it labeled as what it is: a lie.
It’s frightening for me to learn that doctors will lie like this because that means we cannot trust what they tell us. This makes them worse than useless when they misdiagnose and misdirect a patient.
Eventually, we found a doctor specializing in pain who prescribed fentanyl patches that gave my mother-in-law almost 5 years of far less pain than she had endured for decades.
prescription drugs came to be viewed as the reason for the heroin and synthetic fentanyl epidemics. These drugs and the companies that manufactured and distributed them became easy targets for politicians, some of whom piled on by suing these companies with the goal of gaining votes, while an uninformed public applauded their efforts and continued to reelect them.
This has also led to government agencies’ deciding that prescribers have overprescribed opioids.
How they make this decision is a mystery. They don’t have access to patient records, only the number of milligrams of opioid medication prescribed.
How can such a decision be made without knowing what the patient is suffering from and why the opioids were prescribed?
Overprescription by criminal practitioners has been going on for decades. I have overseen law enforcement units that have pursued, charged, and successfully prosecuted dozens of them.
This is nothing new, and it is the responsibility of law enforcement to deal with the outliers without negatively affecting the overwhelming number of legitimate prescribers who are trying to treat patients with pain.
Author: Cmdr. John Burke is a 40-year veteran of law enforcement, the past president of the National Association of Drug Diversion Investigators, and the president and cofounder of the International Health Facility Diversion Association. He can be reached by email at firstname.lastname@example.org or via rxdiversion.com.