The letter by Susan Rosenthal 1 indicates, likely by intention, a simplification tying opioid use to social pain. To me, increasing opioid use has more to do with physicians finally learning that unmitigated pain, especially chronic pain, is no longer acceptable. My own reality is that chronic use with judicious controls (e.g., better acceptance recently for giving methadone for chronic pain) can often allow some reasonable function. As GPs, we are often truly the first to triage for chronic pain patients, but also the option of last resort required to keep prescribing with frustrating “triplicate/duplicate” security-laden prescription pads, periodic urine screening and so on. Being asked to take on police-type thinking on top of all this can be a challenge, very different from the therapeutic impulse that underlies our work ethic.
Footnotes
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For the full letter, go to: www.cmaj.ca/cgi/eletters/181/11/827-a#249094
REFERENCE
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