I just got off the phone with someone who told me his story which is, unfortunately, an all too common story. He has been using opioid medicines for eight years to manage his pain. He tried everything before he tried opioids and these medicines were the only thing that worked to relieve his pain. With these medicines, this 48 year old has been able to work and support his family and interact comfortably with his family and friends.
He had several guests at his house for Thanksgiving and when people left, he discovered that his month's supply of pain medicines were gone. He called his doctor, who did not believe him and who told him to find another doctor. He ended up going to the emergency room and was treated horribly by all of the staff... doctors and nurses, treated as if he were nothing but a pathetic drug addict. He has been frantically seeking someone to treat his pain in his area and has not found anyone willing to provide the care he previously received. He has called everyone he knows and no one has been able to offer help. He called the American Pain Foundation asking if we had a list of pain physicians. We were able to refer him to the usual sources, the American Board of Pain Medicine, the listing with the National Pain Foundation. But we know that no matter how many lists he consults, it is very likely he will not find someone to effectively manage his pain.
That is the undeniable and horrible fact and situation for him and thousands if not millions of pain patients. Here are the facts: for millions of people, opioid medicines provide the best relief for their pain. For millions of other people, opioids are not effective at all and other treatment options work. For those who benefit from opioid medicines it is extremely difficult in most parts of the country to find a medical provider who knows how to treat your pain and is willing to treat your pain.
The major contributing factor to the shortage of providers willing to utilize opioid medicines is the general belief that if you are going to prescribe "controlled substances," you put yourself (your practice and livelihood) at risk of being perceived, investigated or even arrested as a drug pusher. It is not difficult to imagine that you would get duped by a drug addict or drug diverted into prescribing opioids; it is not difficult to imagine that your name pops up on a Prescription Monitoring list as a frequent or "excessive" prescriber; it is not difficult to imagine that a patient's family member would call the State Medical Board complaining about you as "drug pusher" for turning their relative into one who is "hooked" (dependent) on narcotics.
Does any of this ring true in your experience? I want to hear your stories.