Over the past weekend, a patient who had a problem that we were seeing improvement with had an exacerbation of pain which clinically seemed out of touch with the physical picture. Upon questioning the patients daughter, apparently, she had surgery years ago which required pain relief. The patient was given fentanyl patches which relieved the pain. A few years later, combined with the chronic use of fentanyl, the patient had shingles, which normally lasts about two months. Two years after this and the increasing use of fentanyl, the patient was brought to us.
Upon questioning, even though functionally the patient improved, I was concerned about the use of the fentanyl and weather this had become a large part of her problem, rather than something that would just manage the pain.
Apparently, this is an epidemic, where doctors are overprescribing opioid painkillers and patients are getting hooked. Check out this article below. Perhaps the war on drugs needs to start with our local doctors and the way they allow some patients to continue with medications that can have dangerous consequences.
Tightening the Lid on Pain Prescriptions
By BARRY MEIER
Published: April 8, 2012
SEATTLE — It was the type of conversation that Dr. Claire Trescott dreads: telling physicians that they are not cutting it.
But the large health care system here that Dr. Trescott helps manage has placed controls on how painkillers are prescribed, like making sure doctors do not prescribe too much. Doctors on staff have been told to abide by the guidelines or face the consequences.
So far, two doctors have decided to leave, and two more have remained but are being closely monitored.
“It is excruciating,” said Dr. Trescott, who oversees primary care at Group Health. “These are often very good clinicians who just have this fatal flaw.”
High-strength painkillers known as opioids represent the most widely prescribed class of medications in the United States. And over the last decade, the number of prescriptions for the strongest opioids has increased nearly fourfold, with only limited evidence of their long-term effectiveness or risks, federal data shows. Continue reading here