How the opioid crackdown is backfiring

[moriah]

75. .... if you're saying docs shouldn't prescribe for obvious acute (as in, not chronic) injuries...

... then you're coming dangerously close to a position I firmly disagree with, which was exemplified by my ex's family.

When he was 14 he had his four wisdom teeth surgically extracted and four premolars yanked for braces, the doctor wrote about a week of painkillers. His father tore up the prescription in front of the doctor and said his son was going to "deal with pain like a man".

ER docs -- who fortunately can access state PMP databases to see if there have been other recent opiate prescriptions, but don't have the benefit of years treating the pt -- should only give enough to last until they can get to their GP. And GPs, who are not trained to deal with all complications of chronic pain management with routine opiates, should not be writing for much longer than a month -- if the original self-limiting injury isn't healed enough by then, they likely need an orthopaedic specialist if not also a PM specialist.

But I've never had my GP question if my pain was "acute" vs "chronic" when I presented with a unilateral discolored cankle that could bear weight but was obviously not what it preferred to do. Or the broken arm as a kid (didn't feel the pain for several hours from shock, but DAMN that fucker hurt once the initial endorphins wore off). Or when I dislocated my kneecap and the swelling made that knee twice the size of the other.

And fortunately I haven't had that "unilateral discolored cankle" presentation since ankle ligament repair surgery.