By R Carter
There’s a current fad occurring in medicine and healthcare and it’s not the first of its kind. The history of healthcare and medicine is replete with fads promoted by zealot individuals who believe they’ve invented a better mouse trap or by those less scrupulous individuals who have figured out some trickery by which they can add to their bottom line and get rich quick. Other times some fads are simply a reflection of the times, promoted not for their medical value but because of the ideological sentiments held by the individuals promoting them.
This latter group often turns to disinformation as a means of forwarding their agendas. While they may believe whole heatedly in their point of view, the concept of informed consent is often trampled on for the sake of serving such ideological goals.
One of those idealistic fads currently spreading across America is the idea of having surgery without the use of opiates for pain relief in the post-op period. The article below is an example of how such ideas are sold to the American public and in making that sales pitch, fully informed consent is the first causality, the patients faith in medicine and doctors is the last.
After nearly thirty years of practicing anesthesia, I’ve seen all types of patients, some who can tolerate some types of pain with nothing more than Tylenol and others who no matter how much pain medication they’re given, still have unrelieved pain. That’s the unique thing about pain, it is figuratively and literally a personal and individualized experience and there is no one-size-fits-all to pain relief, nor is there a maximum amount of pain medication which is right for everyone.
For that reason, patients should be made fully aware of these facts and be given the option of choosing the type of pain management they will use in the post-op period. After all the patient is paying for this and its their body, those two facts alone give them the final say in how things are done. Denying patients full access to all information available is a violation of do no harm.
MedicineNet.com is not anti-opioid but they are very pro non-opioid in the solutions they promote for pain management as evidenced by this article recently posted on their website.
THURSDAY, June 20, 2019 (HealthDay News) — For people recovering from surgery or dealing with a painful injury, an expert suggests that there are a number of safer alternatives for managing pain than using potentially addictive opioids.
“Today, more than ever before, we have a host of other methods that can effectively lessen pain,” Dr. James Grant, chair of the department of anesthesiology at Cedars-Sinai in Los Angeles, said in a hospital news release.
The United States is grappling with an opioid addiction epidemic. There were 218,000 overdose deaths involving prescription opioids in 2017, five times higher than in 1999, according to the U.S. Centers for Disease Control and Prevention.
Many people become addicted when they receive prescription opioid medications after surgery or a major injury.
The first step in reducing opioid addiction is making patients realize that managing pain doesn’t mean they are going to be pain-free, according to Grant.
“It’s important for patients to understand that when you undergo surgery, you won’t be entirely pain-free,” he said. “We need to manage expectations and make sure patients understand there likely will be some discomfort associated with any procedure. But as days go by after the procedure, the discomfort should progressively subside a little until you get back to your pre-procedure state.”
So where is the misinformation and what’s less than transparent in this sales pitch?
- First is to instill fear in the individual by implying the possibility of death from opiates, sighting a number of overdose deaths related to opiates. Such a remark is completely out of context in a discussion about managing post-op pain, unless the intent of the prescriber is to give amounts of medication which are lethal.
- Overdose deaths which involve opiates occur 90% of the time, in combination with illegal and illicit drug use. In fact there are no records of fact that ties this behavior to hospitalized patients under constant supervision by trained medical professionals. Quoting 218,000 overdose deaths involving prescription opiates is one of the most heinous lies being perpetrated by the anti-opiate mafia.
- The fact that the nation has seen a growing number of overdose deaths from drug abuse is also out of context for a patient going in for elective surgery. The hidden message here is that the patient should be willing to take a hit for the team because there are individuals out there abusing drugs.
- The second lie is claiming that many people become addicted to prescription opiates after they are used in medical situations such as surgery. A more honest statement would be, a small number of people become addicted, and we know exactly what that percentage rate is. The CDC has reported on it often as 0.62% or about one-half of one percent. This hardly qualifies as many patients.
- The third lie is in telling people they can’t go through surgery pain free. That is true to a very small extent, there are times when pain medication wares off and the patient will experience pain before being given more medication. But as used here, this is an attempt to convince the patient that it is better to suffer through with pain for fear of overdose or addiction. Such statements are nothing more than mind fucking a patient into believing that there’s no chance of being pain free following surgery. Patients can have a surgical procedure which for all intensive purposes is pain free, when opiates are used in a rational manner as they have been for hundreds of years.
The current fad within the medical profession, by surgeons and anesthesiologist, of advocating for medical procedures known to be painful while suggesting they be done without the benefits of opiates is duplicitous. It’s trying to have your cake and eat it to. Do the procedure because that’s how I make money, but also be seen as being socially conscious by advocating for pain relief without the use of opiates.
I’ve drawn a good deal of criticism from other healthcare professional for speaking out as I do. Those who don’t do these things take offense, so I want to stress that the behaviors I’m critical of in this post do not occur everywhere, but they do occur in many places. I myself went through a surgical procedure less than a year ago and was sold these same lines. I was offered a rescue opiate if non-opiate means didn’t work. But what they didn’t tell me was that the rescue opiate was such an insignificant amount as to be entirely ineffective. As such I had 8-9 level pain for weeks. So I encourage patients to educate themselves and be specific with doctors about amounts of medication that will be available during the postoperative period. Don’t take what they say at face value and don’t go under the knife until you have assurances in writing on how pain will be managed.
For doctors who advocate this way I suggest we test how strong their beliefs are in these methods. Let’s pound their hands with a hammer and then ask them to get by on Tylenol alone. When they can do that, then I’ll being willing to listen to their sales pitch.