Shades of Grey: a Pro-Patient Approach to Chronic Pain

Opioids have garnered a great deal of media attention lately – much of it I’ve written about and been deeply interested in. As a doctor who has worked with people who suffer from the most severe forms of chronic pain throughout my medical career, I have witnessed both sides of the opioid issue. Many of my patients have benefited from their prescriptions. Many have benefited more from alternative therapies.

Life does not always have clearly defined sides, and sometimes the best answer lies between the black and white. My mission is to help people with chronic pain find some relief, something that cannot be solved solely with opioids or settled by abandoning them. As a physician, my job is to ensure the health and safety of my patients.

I believe that some people with severe chronic pain need opioid prescriptions, perhaps even high doses of opioids. In turn, some might label me as being “pro-opioid.” But how can anyone be truly pro-opioid when these drugs are associated with so much harm? I despise that we don’t have safer alternatives that help more people in pain find relief.

I am pro-patient.

Assessing a solution for a patient is a highly individualized process, in which a physician must weigh all aspects of the patient’s health to provide a recommendation. When physicians look into the eyes of someone in terrible pain and who has nowhere else to turn, we have to make a decision.

I will be the first to tell you that we need safer alternative and holistic approaches to combat pain in a variety of ways. We need payers to cover these approaches so that all patients have access to them. And we certainly need policy and money to catch up to patient needs. Sadly, we are at a time in chronic pain’s history when patient needs and existing treatment approaches simply do not match up.

Until better, safer treatment is readily available to patients, opioids remain one solution for some chronic pain patients to find a bit of relief. The probable beneficence of the treatment outweighs its possible maleficence in their case.

When faced with pain, we do the best we can. In the debate over appropriate treatments for chronic pain, I say, let compassion lead us forward, and let science light the way.

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