My patient was in pain. I didn’t know whether to believe himFor the first time during his hosp

My patient was in pain. I didn’t know whether to believe him

For the first time during his hospital stay, his pain became real to me, and I realized I had wronged my patient by not taking his complaints more seriously. We gave him an opioid for his pain, and, slowly, the pain in his finger improved.

We’re taught in medical school not to undertreat pain, yet we do it too often in our zeal to not promote addiction. But many people who misuse opioids started out seeking pain treatment. We’re not doing enough, but what more can we do?

Don’t get me wrong. We absolutely need to continue to ask questions. We need to be more responsible when we prescribe these powerful drugs. And, yes, we need to remain vigilant for any signs of drug-seeking behavior.

That said, we have to be a little more trusting of our patients when it comes to their pain. Getting better control of their pain may help them recover faster and stay healthier longer.

With the opioid overdose epidemic, there is a palpable resurgence of very conservative pain management.  We need to recognize that some people need opioids for pain management. Ultimately, substance use disorders and overdose are largely driven by disconnection, trauma, and stigma surrounding drug use, not the drugs themselves. Let’s evaulate and change the environments within which people are using drugs (i.e. address the social determinants of health, including employment, education, housing, and income).  Limiting the conversation to restricting people’s access to medications obstructs a larger conversation on how our environments shape health behaviours.