April 12, 2005

(Editor's note: This is an article that originally appeared elsewhere, revised to bring it up to date.)

What is "pain"? The official medical definition of pain is: ...whatever the experiencing person says it is, existing whenever the experiencing person says it does. The person with the pain is the only authority about the existence and nature of that pain, since the sensation of pain can be felt only by the person who has it.

When that pain is not believed, and not made a priority by those who care for the patient, the suffering can be unimaginable. It goes on every day.

No matter how many times we are told that "patient rights" and good care are important to those who are in control of medicine today, the fact remains that the patient doesn't have any "rights" not granted to them by the bureaucrats and the medical establishment.

This is especially true when it comes to pain management, no matter what the source of the pain or the situation of the patient. The government and - to a much lesser extent - the doctors have total control over the medications and treatments needed for meaningful pain management. It is very, very obvious that their goal isn't pain control - it is DRUG control!

Far too many people, from the legislatures down to the corner drug store, have 99% of their efforts directed toward preventing anyone from getting something they supposedly shouldn't have and seem to miss the fact that 99% of the people are NOT getting what they really NEED because of it! Add to that all of the people who have bought in to the false claims and fears broadcast by the controllers, people in pain who are too fearful to accept relief when it is available! Imagine suffering terrible pain because of a false fear of "addiction". It happens every day.

What is wrong with this picture?

Don't believe it?

The first thing to realize is that doctors are seldom the best at listening to patients and understanding their description of pain to start with. Far too few doctors have any real training in assessing and treating pain. They understand the drugs and their interaction with other drugs and treatments, but they don't always understand pain and its affect on people.

Some nurses, however, do understand all of that and more. They have special education in pain management and pharmacology, especially nurses who serve patients with cancer and other serious pain. It doesn't do any good, however, unless we can "sell" it to the doctor... who spends little time, if any, with the patients. Unless he is open to learning, it can be a "hard sell" to say the least. Many doctors have the same false fears of "addiction", and all of them are deathly afraid of the DEA with good reason.

But all the statistics and studies prove without a doubt that good pain management is the most important part of the overall treatment where pain is a problem. In the terminal, it is vital in order to provide any meaningful quality of life to patients or their families.

Other than "drug control", there is simply no reason for anyone to suffer from severe pain, "terminal" or not!

Contrary to common misconception, morphine is the drug of choice for moderate to severe pain, not the "last resort"! It is the gold standard of pain medication, and the dosage of other preparations are predicated on the 10 milligram base dose of morphine. That is equivalent in pain relief power to two regular aspirin. Yes, really.

In a process called "titration", the medication can be fine tuned to match the need of the patient, no matter how much may be required to control the pain. Since Morphine has little or no adverse reactions in the liver or kidneys (unlike most other pain drugs), there is no upper limit on dose when pain increases. We can give as much as it takes to relieve the pain. (There are some kinds of pain for which opiods are not effective, but that's another story.)

In the same way, when and if the pain decreases or goes away, the medication is titrated downward until both the pain and the medication are gone from their lives. There is no problem with true "addiction" in people who take morphine or related drugs for serious pain. When the pain is gone, and they are weaned off the physiological dependence, there is no more desire for the drug at all. This is a well documented and well proven fact. Only those who have used drugs for non-medicinal purposes - the true addicts - are at risk, and even many of them can be successfully managed on morphine when they have serious pain. They can be managed and weaned off with far less trouble than most people who quit smoking have.

Morphine has fewer serious side effects, especially with long term use, than most other drugs. Those few side effects are well known and easily controlled. Without the DEA and all the other drug "warriors", morphine would be cheap and plentiful and so would save millions of dollars a year now spent on the artificial tight supply, paperwork and other garbage generated by the "control".

Almost all medications are considered "controlled substances". Narcotic analgesics and some psychotics are "controlled" even more and require a special prescription form known as a "triplicate". These can be written only by medical doctors who have special permission from the state to do so. They are complicated, time sensitive, and costly. The doctor must pay a great deal of money every year for this "privilege".

The DEA and various other government entities endlessly monitor the usage and disposition of these special prescriptions and are ever ready to persecute (the "controllers" seem to have the mind set that we are all automatically criminals and idiots) doctors who write them "too freely" or pharmacists who may cut corners on the red tape to provide medication to people in pain. The control is arbitrary and those who run afoul of the controllers can face stiff fines, loss of "license" and even prison for their compassion. None of this has anything to do with drug abusers or addicts, even if that were a legitimate concern of government. Those people in pain are your loved ones, neighbors, friends, and maybe even yourself.

There are people who deliberately misuse some drugs, alcohol, etc. There are some who are not careful and who harm themselves as a result. There always have been and there always will be some people like this. That is human nature. All the laws and restrictions in the world will not stop them.

There are people who use things like drugs and then go out and hurt other people. There are plenty of laws against hurting other people. Those laws need to apply whether that harm was done under the influence of a drug, too much to drink, or just a vicious personality. Extra laws to restrict the drug or drink or the personality have no impact on people who wish to do harm and do not prevent them from doing so.

Given that, what is the purpose of all this "control"? It doesn't help those who are harmed by it, and it certainly doesn't help anyone who has pain. What is it? Job security for bureaucrats? False security for those who can't imagine taking personal responsibility for themselves, and can't imagine that anyone else can either? Why?

Sadly, far too few of us have ever thought of it this way. Too many have accepted the idea that all drugs and such must be controlled by the government so people won't hurt themselves or others. They don't think about how these restrictions cause countless people to suffer untold agony because of the drug phobia manufactured by the controllers. Think about it.

Why do we put up with it? What can we do about it? Please share your experience. What can we do?

Please send your feedback and let me know if you've found other good sources for information on traditional or alternative health care that is backed with clinical trials and solid science. No snake oil, please.

Archives

Changes

An Invitation To Participate

For Her Safety

The Valley of the Shadow of Death

Are We All Wasting Our Time?

Standing By Our Mission

Free State Project - What is going on?

A Gift For Granny

Forced Righteousness?

The Meltdown of Western Medicine part 1

The High Cost of Medicine part 2

Don't look now (is it already too late?) Part 3

Take Charge To Get The Best From Your Health Care Providers

Who's Body Is It Anyway?