Lessons from Two Untimely Deaths

By | March 21, 2012

The real tragedy in these two deaths would be if the rest of us learned nothing.

As I said in yesterday’s blog the untimely deaths of George and his patient are tragic, but what should we learn from them. First and foremost, narcotics kill. Opioids are tremendously useful in the temporary modulation sensation of pain, but have little or no place in the treatment of chronic pain. I do not believe that I have ever seen a patient on oral opioid therapy for chronic pain that was really better off. Secondly while I firmly believe that the first person perception of pain is incorrigible, the response should not be automatic. I may believe that a patient really is experiencing pain, but decide that narcotic therapy is inappropriate. At Schlesinger Pain Centers the primary goal is to find the underlying cause of the pain and to treat that cause rather than just the symptom of pain. While medical management is an adjunctive part of the treatment of many chronic pain patients, at Schlesinger Pain Centers oral opioids are used in the treatment of only a minority of the patients and always with the goal of tapering the dose as rapidly as possible. Finally, I have learned to listen to that little voice inside my head that tells me from time to time that x, y or z may not be such a great idea. Bad things happen even to good people. Whenever I embark upon a new therapy or even continue an old one I always ask myself, “Suppose this all goes badly, would you be able to say that I would still do it the same way?” If not, maybe it’s time to change my plans.

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