Should We Believe Patients With Pain?

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 burke@rxdiversion.com or via rxdiversion.com.

12 thoughts on “Should We Believe Patients With Pain?

  1. Chicago Deb

    Another vEDS patient died. I thought, oh she must’ve died of an aortic dissection.
    Nope. Few days later I found out it was suicidal due to pain.
    Her name was Tara.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      That’s just awful.

      I had a bad pain flare this morning and can’t imagine what I would have done without opioids – I’m so incredibly lucky to still get them.

      Like

      Reply
  2. leejcaroll

    Initially the doctor who had dies several “decades “earlier was of the time when doctors may well have believed that about narcotic meds, and in those days a doctor’s “advice” was considered to be the be all and end all (altho in 1976 when my trigeminal neuralgia started (the first pain disorder to be called “the suicide disease” and “the worst pain known to man” gave me a script for an 8 ounce bottle of tincture of opium and then many other narcotic scripts, altho known helped my pain).
    I bristled at the title of your article. Imagine if someone wrote an article entitled Should we believe patients with cancer? That would be unheard of and insulting to many.

    Liked by 1 person

    Reply
    1. canarensis

      I thought the title of the article was perfectly reflective of the reality of the life of chronic pain patients: I’ve had hideous migraines since the late 70s, up to 20 days/month, & constant dreadful pain (24/7/365) since a surgery in 2001. Bad back & fibro for 15+ years. In all those decades, the number of doctors & laypersons who actually believe I have real pain is very, very low. The answer to the title should be, of course, “Yes we should!” The reality is, for the most part, that the only people who believe patients with pain are other pain patients….especially in this climate of anti-opioid hysteria, lies, & insane anti-science policies which is driving the national (false) narrative.

      Liked by 2 people

      Reply
    2. Zyp Czyk Post author

      Yes, it’s a retrials question to pose, but it’s the way doctors (and law enforcement) approach pain patients. We have to “sell” our pain to our doctors, because they’re not sure whether they should believe us.

      What a ridiculous situation, when we see a doctor for a symptom, and they don’t believe it’s really as severe as we say, if they even believe it exists at all. They may be doctors, but they are certainly not healers anymore.

      Liked by 1 person

      Reply
      1. canarensis

        Zyp; that is certainly the truth; they’ve gone from healers to torturers, with a few beleaguered exceptions.
        And if we act as if we’re in pain they accuse us of faking it & being histrionic; if we do stoic, they say it’s proof we’re not really in pain. Talk about yer Catch-22 situations…but then, you already know alllll about those.
        *sigh*
        will the madness ever turn around?

        Liked by 1 person

        Reply
        1. leejcaroll

          My point was that no one would dare ask that if it was a cancer patient.
          My trigeminal neuralgia is from a neurovascular birth defect, I was perfect textbook, absent my age (too young) altho since I was dx’ed the signs and symptoms have changed and now all ages are included.
          An outward manifestation was clearly visible by a vascularized birthmark, that changed color if I was in an emotional state, did physical exertion etc. It was textbook for the birth defect and anatomically in the exact geographic (if you will) area of my trigeminal neuralgia which was anatomically correct for the part of the nerve that was affected.
          It was also verified during my first neurosurgery where the cause was easily identified and cleared off ,which stopped my pain for 3 months until it returned because the blood vessels grew back. Nevertheless some subsequent docs doubted the pain, doubted I had trigeminal neuralgia, and some treated me like I was some dirt in the street so I have been there and done that.

          Liked by 1 person

          Reply
          1. Zyp Czyk Post author

            They just don’t *want* to know you’re in pain – then they’d have to do something about it. I cant believe how cruel they were to you when you have such an extraordinarily painful syndrome.

            Liked by 1 person

            Reply
            1. leejcaroll

              Canarensis. I am so sorry that she had to endure that. (I recall in the 80’s my friend was dying of bodywide cancer. She was in a good NYC hospital. Her pain was horrendous. I went out to nursing station and pleaded with nurse to give her something. Nurse said Im sorry hospital rules only every 4 hours no matter what. I replied “I have trigeminal neuralgia and I am on up to 14 grains of codeine some days. Why can;t you give her more?” The nurse responded “Because she’s in the hospital and youre not.” Seems the rules in and out of hospital have changed places to some degree with hospitals now, many at least using dont know real name but pain med dispensing machines at bedside so patient can control the amount of pain meds (up to a point of course) and many of us on the outside suffering because of the rules, some made up purely out of fear of the fda and cdc.
              (and thaks Zyp)

              Liked by 2 people

            2. canarensis

              lee; thank you. I’m not particularly religious, but am desperately hoping there’s a special place in Hell for all these medical torturers. I had an elderly neighbor who passed away the other day, and was on hospice for the last couple weeks. I was astonished that they brought him some morphine syringes when his Norco wasn’t doing enough…here in “No opioids Oregon,” no less. Can’t tell you how glad I was that he didn’t die in agony. He really did look as if he went to sleep & just didn’t wake up…& the sleep was peaceful. Don’t know how the Oregon Zealots missed him.

              Bizarre & enraging that they tortured your friend with cancer like that because she was in a hospital. So very twisted.

              Liked by 2 people

            3. leejcaroll

              Hospice has been a blessing, in every definition, ie religious or not ((*_*)) My friend ultimately went to hospice and was drugged almost all the time. When I asked a nurse if they were going to “snow her the nurse said No but gave me an expression that I read as “yes: But she died the same way as your neighbor. (snowing which you may or may not be familiar with has been done for long long time (secretly) they give the morphine (or other narc) and give each dose before the prior dose is out of the system so essentially it is a slow term overdose. It is sad that doctors who are just trying to be compassionate, caring and doing the best for thier patient even if death is the right answer have to hide it.

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          2. canarensis

            Lee; sorry to hear you got so abused for such a diagnosable condition…somehow that seems worse than when the pain source is “invisible.” And it just enrages me that probably every CPP in the country has been there & done that.
            Things have gotten insane enough that now clinics are bragging that they don’t prescribe opioids for cancer pain…long considered more “real” somehow that non-cancer pain. Tho when my mom was dying of leukemia in 1997, they refused to give her anything at all b/c it was getting known that some jackasses were abusing oxycontin in Georgia. She died in unspeakable agony, weeks of it. Part of the reason that this whole insanity is seriously driving me insane with rage.

            Liked by 1 person

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