Posted by ed_uk on March 8, 2005, at 10:35:59
In reply to Re: Do they like to see us suffer?, posted by Optimist on March 8, 2005, at 9:50:16
Hi,
My opinion........
Doctors who fail to provide adequate analgesia are not fit to practice. The provision of good pain relief must always be a top priority, something which should be emphasised greatly during medical training. There is nothing more vile that refusing to prescribe opioids to patients in severe acute or chronic pain who really need them. The commonly held opinion that chronic pain should not be treated with opioids unless it is due to cancer is particularly ridiculous. Thankfully, many doctors are now willing to treat non-malignant pain with the necesssary medication. Clearly, opioids are not necessary for everyone but they do need to be available for the times when they are. Like all treatments, opioids need to be prescribed with care, this is not unique to opioids.
One of my friends relatives is currently dying from kidney cancer. I was pleased to hear that she is currently being sucessfully treated with a titrated dose of controlled-release oxycodone (OxyContin) and can take rescue doses of immediate-release oxycodone (OxyNorm) when necessary for breakthrough pain.
If she had been in severe pain due to a chronic non-malignant condition, what would have happened if she failed to respond to acetaminophen, codeine or an NSAID? What often happens is that people have to live with agonising pain on a daily basis, often for many years, partly due to poor resources and a shortage of pain specialists. Opiophobia is common and many people are therfore refused treatment, even when there is no reason to believe that the patient would abuse or sell their medication. Patients must never be denied analgesia because some people abuse their medication, this is something I strongly believe in. More pain specialist are urgently required in the UK, most patients never get to see one. As a result, many people are treated by practitioners who often have very little knowledge of analgesics and have little idea of how to use them. If opioids are appropriately prescribed, respiratory depression is almost unheard of. Physical dependence is inevitable if opioids are used on a long term basis but true 'addiction' is not so common. If I was in severe pain, I would gladly accept physical dependence on any medication that could relieve my pain.
Regards,
Ed.
poster:ed_uk
thread:468106
URL: http://www.dr-bob.org/babble/20050308/msgs/468214.html