Over the past several years, chronic pain and the use of opioids have been a dominant topic of conversation and a primary focus in healthcare. Tragically, in our attempt to improve the pain management in those we serve, an epidemic of narcotic misuse, abuse, and dependency occurred. To stem the rapidly increasing opioid crisis, the focus on fixing the problem has pivoted to the regulation and guidelines for implementing and dispensing of these medications.
Unfortunately, two things have occurred. These actions succeeded; they lessened the use of opioids. However, they did so indiscriminately. Secondly, new ways to manage chronic pain have not been established as a substitute for opioids.
As a result, Clinicians are in a situation where there are limited options to use opioids across the board, and no new ways to improve the pain of those they serve. Unfortunately, this scenario leads to the worst situation imaginable for all. The pendulum has swung too hard.
We must focus on the appropriateness of narcotic use by looking at each situation and remembering that chronic pain is a disease that requires treatment. Furthermore, we must establish newer methods to manage pain. The complexity of pain management and opioid addiction within the polarity of people requires innovative treatment with modalities that do not have untoward consequences. Whether better education occurs on how to treat chronic pain; or investment in specialty care, we must enhance our thinking to determine what the patient needs from a clinical perspective. And we must do so in a way that is reverent to their needs.
Simultaneously, we must not perceive Clinicians as the “bad guys” for wanting to help their patients by mitigating their pain. Thus, we need to maintain an attitude of compassion and understanding of their situation and provide the necessary support and education. More importantly, just as with any other disease state, we must invest in the continued improvement of treatment modalities.
We arrived at the current situation because of our strong desire and willingness to help people. Yes, we have caused problems in our attempt, but now we are hurting those we were initially trying to help. Let us step back and address these issues in a manner that delivers on our goal of helping those in need in such a way that does not increase harm. Solving one side of the equation itself is not enough. We must live in the complexity, rise to the occasion, and alleviate as much suffering as possible.