TREATING PAIN-THE NEW RULES
By S.Nasry, M.D. July 2017
Pain is a dreadful and hated symptom that can disturb people's life and paralyze their daily routines, stop them from working or reduce their productivity and sometime destroy careers and ruin future.
Pain is a manifestation of a body derangement that our creator gave us as an alarm so we can seek a cure and not to be tortured, the great majority of pain causes are curable or treatable from heart attacks to broken bones, almost all with proper treatment -except for the terminally ill cancer patient and rare other illnesses- pain quickly abates with proper treatment.
It has been our practice to provide pain medications with some liberty to those visiting our clinics with acute illness or trauma as long as we can verify a disease process that causes pain. It is my belief as a physician that it is my duty to combat pain whenever there is an honest patient with legitimate cause of pain.
Over the last 5-10 years a new problem has emerged or become more significant, it is the Narcotics dependence and addiction. while physicians were trying to wipe out pain narcotics started causing especially when used or abused for extended period of time-started causing a new catastrophic problem, instead of curing pain and putting people back on the normal life and productive work track we derailed their destiny to a miserable life of incapacity and drug seeking behavior. what went wrong? Many factors played a role including the loose surveillance, the blind doctor patient trust and patients selling their medications and sometimes using it more frequently and for longer period than medically recommended just like street drugs!!!
The CDC (Center for disease control) took the initiative in March of 2016 and published guidelines for physicians to follow aimed at reversing the Narcotics dependence epidemic, the net result was much less pain pills recommended for acute pain and much stricter surveillance and tougher rules for chronic pain management. In addition, we now use routinely MAPS system (Michigan Automated Prescription System). It allows us to see all controlled meds prescribed by different physicians for one patient on line So when people are coming to our clinics for chronic pain evaluation we can quickly tell if they have been "Narcotics shopping" seeking meds from multiple prescribers or using different pharmacies.
Our dear patients just like the stricter new rules for antibiotics prescriptions (please see the June newsletter) we are now entering a new era of pain management and you should expect less pain pills probably enough for 3-5 days only (CDC Rule) simply because now we have DUAL RESPONSIBILITY: