By R Carter
The Surgeon General implies that acetaminophen (Tylenol) is equally efficacious to intravenous (IV) opioids for pain relief. Apparently, his comments are based upon, Comparison of the Analgesic Effect of Intravenous Acetaminophen and Morphine Sulfate in Rib Fracture.
If you follow the news on the opioid crisis then at some time you’ve probably come across articles outlining the history of how it began. There are a handful of stories with slightly different details but nearly all include references to papers published in leading medical journals which influenced the medical profession to take a more liberal attitude towards treating pain. Around 1980 or 90, documenting a patient’s pain level was considered the 5th vital sign, viewed as important as blood pressure, heart rate, respiratory rate and temperature.
All that effort and forward progress on treating pain has come under attack since 2010 because of the rising death rate associated with opioids. Armed with nothing more than coroner reports and the number of prescriptions written, public health rushed to judgement and proclaimed the death rate was due an excessively liberal prescribing of opioids.
Not too long after that these same medical journals began publishing letters from experts claiming that opioids were no more effective at treating pain than drugs such as aspirin and acetaminophen, sitting case studies using population groups which used a small number of participants, usually less than 100 patients.
As any honest and respectable healthcare provider knows, it takes research involving hundreds of thousands of patients before such evidence can become significant enough to change a well-established treatment paradigm.
Anti-opioid proponents use case studies done with just a few hundred participants, in their anti-opioid rhetoric as a means of swaying the views of other healthcare professionals and the public, while at the same time condemning such case studies which are pro-opioid, it’s hypocritical. This is what happens when men of science hide behind their credentials and become ideological, political agents as opposed to rational and objective healthcare providers. It’s a sad state of affairs for healthcare and a cancer on American society for those who sell themselves out for such so called ideals. The continued misdirection and anti-opioid rhetoric has led to denial of care for thousands of patients, some who have cancer as cited in this article on Pain News Network.
It represents what happens when our chief medical officer, the US Surgeon General, becomes a politician and not a medical professional. Using his medical degree as a pedigree for bad science, betraying the trust of the American people rather trusting their ability to understand the details of what’s at stake and letting them choose rather than having their choices limited by false claims and misdirection.
Healthcare professionals must follow a legal president called informed consent before treating a patient, to ensure the patient is fully informed of all options and possible outcomes before choosing a course of action. Apparently our chief medical officer for the country is above this requirement in his current blanket endorsement for not using opioids.
Fortunately we live in a democracy where it takes the consensus of thousands of medical professionals before such comments become the standards of care. I pray that is enough to thwart the betrayal of the public trust by those who no longer believe in full disclosure or a patient’s right to choose and have control over their own bodies.