Pain management in the United States is terrible! This is especially true of the elderly and it is a pet peeve of mine so please forgive me if I go off on a rant. I have fought this battle for more than one patient and my own mother and I find it frustrating that I am still fighting it in this day and time.
I do not know if healthcare professionals realize how severe chronic pain can be or if it is fear of reprisal from our current anti-drug environment but it is past time for people to come into the twenty-first century and take advantage of the resources available to them. With the knowledge and the medications available to us there is no reason for people to suffer in pain. To do so is not only unethical in my opinion but cruel.
Pain is often called the fifth vital sign and I really wish that professional caregivers would check it at least as often as they do the other vital signs. While acute pain serves to tell us something is wrong and prevent further injury, chronic pain serves no purpose and can have severe consequences. A person living with chronic pain is often depressed and even suicidal. Their quality of life is lower, they lose strength due to lack of activity and normal activities become harder.
When in pain, the surrounding musculature tightens, exacerbating the pain. To make matters worse, as the pain goes on the nerve fibers get even better at transmitting the painful impulses and the brain signals the pain intensity up trying to get your attention. The result is that even though the pain might not be any worse your pain level is! It quickly turns into a vicious cycle.
While the goal of acute pain is to alleviate it, this is seldom possible with chronic pain. The best you can hope for is to control it. This means it needs to be treated just like any other chronic condition such as diabetes or hypertension with diet, exercise and daily medication. Unfortunately this is not what happens.
Some doctors are reluctant to use powerful pain medications known as opioids (also known as narcotics) to treat pain even when non-opioid medications have not worked. As one doctor told me; the more you take, the more you need. My response was, “So?” Elderly people in particular are leery of using narcotics because of either the side-effects or fear of addiction. We fought for years to get past this same mentality for cancer patients but we have made very little progress for those suffering from chronic pain.
Even doctors are afraid of making an elderly person addicted. Really? The ignorance on this subject is amazing in part fostered by our government anti-drug campaign. (That is the subject I will address in the future). The truth of the matter is that if you are in real pain you will not become addicted to pain medication. That is as silly as my grandma not wanting to use her oxygen for fear of becoming addicted to oxygen.
Am I comparing pain medication with oxygen as necessary for life? If you are in chronic pain, then yes I am. When you live in pain your body is in constant stress, producing chemicals that literally damage your heart as well as the rest of your body, not to mention the mental and psychological toll. I said it before and I will say it again, there is no benefit to chronic pain. It can in fact lead to an early death.
In their defense doctors live in fear of investigation if they prescribe too many narcotics and I do understand that. Even if they do not get fined or lose their license, their reputation is affected as well as the time, aggravation and financial strain of defending themselves.
As a society we have decided it is more important to prevent a drug-seeker from getting their fix than to alleviate the pain and suffering of someone whose only relief comes from narcotics. Because of our backwards priorities, we are letting good people suffer.
If your elderly parent is suffering from chronic pain, be an advocate for them. Talk with their doctor and if you do not get the results you want, get a referral to a pain specialist. Medication is not the only answer but it is one that needs to be included.
Next up, some things to try before you try narcotics.