The New England Journal Medicine concluded that we have doubled our suicide AND overdose fatalities since 2000. Not just overdoses. I know we are all talking about patients accidentally overdosing and that’s a huge prob and that’s whats in the news. Im afraid one of the connections to death that’s not in the news and not really talked about is suicide and how uncontrolled pain and suffering triggers this. Opiates are used in suicide ⅔ of the time!. So now we have folks killing themselves by accident and on purpose.
Here is my big worry. So now that doctors have swung all the way to the other side (the pendulum having figuratively slammed and embedded itself firmly in the wall) no one is willing to provide any pain management treatment. What purtubes me is that so many of my colleagues feel that the trick to curing the opioid crisis is to just turn and look away and just not do anything… I remind them over and over, just because we want to reduce the opioid deaths doesn’t mean you don’t treat them at all. You have to start somewhere. For those patients that aren’t already dependent or addicted don’t get them addicted and for those who are already addicted manage them and help the remove/reduce’eliminate the addiction WHILE at the same time working on all the other pain management tools at the SAME time. Don’t just pull the rug out from under them. What we do there is pull out the hope for a future. WE know that there are other options but it’s not about us right? It’s about the patient and if you don’t spend more time on how we will work diligently on pain control in other areas while at the same time compassionately reducing and weaning down the opioids we pull out the hope from under them. Is it surprising to anyone that one might feel suicidal when they don’t feel any hope or that anyone cares about their pain? The get the feeling that we are more worried about getting them off opiates than helping their pain. We need to consider BOTH things at the SAME time. Give them hope and encouragement that we will work on other excellent pain management tools and at the same time show them that we do care that they are in a predicament (sorry that we doctors put them in a predicament)…
No more rug pulling!. This is a delicate dance where all wheels are moving at the same time and our eyes are locked onto the patient’s eyes for cues, for hints for ideas for feedback, for frustration and for hope!
Andreas J. Edrich MD FASAM ADM MRO “the addiction doc”