> There are already far, far too many examples of physicians not trust patients about pain.
I am friends with a couple of ER doctors, who are probably the worst offenders (self-acknowledged) in this space. It's based on a real phenomenon, though, of drug-seeking behavior.
As people with chronic pain communicate with each other (through things like Reddit) on the best way to communicate to doctors that their pain is legitimate, those techniques are also inadvertently taught to other people who are seeking pain medication for recreational purposes.
I think the cause of widespread drug legalization has been weakened by a couple of real world efforts in that direction, but I still stubbornly cling to the belief that if people are allowed to make their own choices, then you can partition the recreational users from the chronic pain sufferers and maybe let medical science have a slightly better change of addressing the latter case. That said, given factors like cost and insurance coverage, it may just be a realigning of incentives rather than fixing the problem itself.
> but I still stubbornly cling to the belief that if people are allowed to make their own choices, then you can partition the recreational users from the chronic pain sufferers
I can empathize with this thought (having had an episode of pain disbelief in a hospital myself) but the idea of partitioning recreational users from chronic pain sufferers isn’t reflective of the reality.
They aren’t two mutually exclusive groups. In fact, many recreational users get their start from over-prescribed opioids. Some people experiencing pain and all of the associated emotional difficulties will see the sudden access to opioids as an opportunity or even an excuse to indulge in opioid excess.
Self-medication with opioids also produces a very quick on-ramp to dependence in average users. If you’re anything like me, you prefer to use the minimum dose of any medication and get off as quickly as possible. I’d rather have mild lingering headache pain than take an extra Ibuprofen.
Not so with the much of the general public. I have friends in medicine who believe even Tylenol should be prescription only because of how frequently they see people destroying their livers by taking excessive amounts. Look at simple drugs like Afrin nasal spray and people who become severely dependent for months or years because they can’t even read the directions on the bottle. Open this same door to something euphorically reinforcing like opioids and the number of people walking themselves straight into addictions because they wanted something stronger for the occasional headache would be massive.
>> you can partition the recreational users from the chronic pain sufferers
Except that you can't. There is no bright line between those two groups. Many recreational users/abusers started their journey when prescribed drugs for legitimate pain. Steady use becomes dependency, then you look for other sources, and quickly you are crawling dark web for a dealer in your neighborhood.
I am friends with a couple of ER doctors, who are probably the worst offenders (self-acknowledged) in this space. It's based on a real phenomenon, though, of drug-seeking behavior.
As people with chronic pain communicate with each other (through things like Reddit) on the best way to communicate to doctors that their pain is legitimate, those techniques are also inadvertently taught to other people who are seeking pain medication for recreational purposes.
I think the cause of widespread drug legalization has been weakened by a couple of real world efforts in that direction, but I still stubbornly cling to the belief that if people are allowed to make their own choices, then you can partition the recreational users from the chronic pain sufferers and maybe let medical science have a slightly better change of addressing the latter case. That said, given factors like cost and insurance coverage, it may just be a realigning of incentives rather than fixing the problem itself.