I’ve noticed a frightening trend in the latest research on patients taking prescribed opioids: whatever the negative outcomes, researchers attribute them to the opioid medications instead of the underlying pain. The many detrimental outcomes thes…
Category: Pain Management
Medical care was never intended to be a daily fights against insurance companies
Last month I saw Joan, a woman who has had low back pain for years. She’d been through the ringer like every other person in severe pain: countless procedures and medications. She continued to have daily pain that stopped her from staying focused at wo…
Take the naloxone challenge
Last week I took the naloxone challenge. I walked up to a pharmacy window, waited in line, and requested naloxone from the pharmacist. She showed a supportive but knowing look, and I became acutely aware of the four people in line behind me. After givi…
The value of personal narratives in addiction treatment and integrated care
I was standing behind my trolley in our local supermarket when, in my wallet, I came across that drawing of a human heart. In the miniature pen-and-ink composition, the heart is suspended between two birds’ wings. At the bottom is a dateline: Opioid Vi…
Why staying ahead of your pain with opioids is the wrong advice
I often hear the mantra, “You must stay ahead of your pain, or else.” The president of the American Academy of Pain Medicine, states a common mistake people make, is waiting too long to take pain medication. By the time you’re in pain, you’re starting …
A patient’s opposition to the anti-opioid movement
I recently read an article — “California Doctors Alarmed As State Links Their Opioid Prescriptions to Deaths” — that infuriates and frightens me I’m furious that doctors are being persecuted for opioid prescriptions writte…
We need RVUs for obtaining a prior authorization
I haven’t counted how many times this happens every month, but I find it annoying. I send a prescription for a drug (sometimes not even expensive) to the pharmacy and soon after, I get a fax asking me (or my medical assistant) to go online and print a …
A paradigm shift in acute pain assessment and management
We have embarked upon a unique strategy to assess and manage pain. “Opioids Rarely Help Bodily Pain” is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradi…
How opioids can destroy the most beloved of personalities
“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-…
How opioids can destroy the most beloved of personalities
“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-…
