As we all know, the press has been emphasizing, quite rightly, increasing numbers of death and disability secondary to painkillers especially narcotic painkillers such as oxycodone, OxyContin, morphine, and other narcotics. One of the strategies that the medical authorities are considering is to try and limit doctors from prescribing these medications, especially in those patients with chronic pain.
A few years ago, I underwent a fairly extensive operation and was placed in a study that limited my narcotic usage to three days after the surgery. Needless to say this experiment was an absolute failure. I was still having considerable pain despite the introduction of other painkillers such as Tylenol without narcotic, aspirin, and nonsteroidal anti-inflammatory drugs which are also painkillers. None of these alternatives worked and I had to be placed back on the narcotic for another five days in decreasing dosages.
I encountered a number of patients in my practice recently before I retired, who had been taking my narcotic for many years for intractable pain secondary to inoperable back pain. They were having a great deal of difficulty obtaining their narcotic, despite the fact that many of them had been living quite comfortably with a relatively small dose of narcotic for many years. These patients had no symptoms of addiction and they did not think that they should be suspected of being an addict because they have no other recourse but to take a narcotic to relieve their problem. Some physicians now, under pressure from the various authorities that control medicine, refuse outright to prescribe narcotics. Many directives have been sent to physicians in regards to this problem and is freely putting the doctors in a terrible position. I will admit that there have been positions of abused the prescriptions of narcotics, and have been practicing out of what are called “pill mills” and of course they should be closed down and the physicians should be retrained or prosecuted. But I believe that these physicians are in the minority and all physicians should not be targeted because of a few bad apples.
Finally,if you are in need of pain relief,and consult a physician be certain that all causes of the pain are ruled out, and all alternatives to strong narcotics are attempted including, minor pain relief drugs, nonsteroidal anti-inflammatory drugs, (which have their own problems as far as complications are concerned) acupuncture, chiropractic, and such psychological approaches as meditation etc.