We don’t seem to understand it. We are not that good at controlling it. We are becoming better at addressing it. We have a long way to go.
There was a post on My Lymphoma Journey addressing this issue and it really got me thinking.
We are just leaving the declared decade of pain control and research. So, where are we? Pain is now the fifth vital sign. Hospitals, doctors, and drug companies are now more attentive to the issue and attempt to relieve their patients’ agony. There are still areas for awareness improvement. For example: Medicare reimbursement, at some levels, is dependent on functional improvement. Sleep and pain are not considered functional. Therefore, a person can have 9/10 pain while trying to get dressed (after a sleepless night) but as long as they can get dressed independently they do not need treatment.
There are some great new medicines on the market to help with pain control. There are some to help neurogenic pain, such as Neurontin and Lyrica. (Hard to miss all the Lyrica commercials). These are not opiate based. Rather they seem to have their roots in seizure control medicines. They do have their own side effects but can be very helpful.
Drugs, such as oxycodone, are being used to treat everything from acute (new) pain to chronic (long term) pain. It is very powerful and has a pretty high street value. Due to the abuse and over prescribing by many individuals, states are beginning to crack down on its use. This includes more paperwork for doctors. While making sure medicines are used ethically and as intended is very important, especially with narcotics, the increased paperwork and investigations have meant a new barrier to access. Some doctors stopped prescribing it in order to avoid the whole issue. Some pharmacists try to avoid it for the same reason. Who wants to go to jail or lose their license because they did not research their patients’ lives enough. I witnessed a doctor in the hospital accusing a patient of being a wimp and a “clock watcher”. Only to discover later, he just did not like all the paperwork that he had to do every time he prescribed pain medicine.
An issue of particular importance for chronic pain patients is opioid-induced hyperalgesia.