What a bunch of bullsh... What drove the opioid epidemic was the Federal Government. Starting in the late 80 early 90 pain management became a big deal. At that time Medicine was generally accused of not caring of patients were in pain. Nursing curriculum changed "pain as the 5th vital sign".... The Joint Commission would come in and dec…
What a bunch of bullsh... What drove the opioid epidemic was the Federal Government. Starting in the late 80 early 90 pain management became a big deal. At that time Medicine was generally accused of not caring of patients were in pain. Nursing curriculum changed "pain as the 5th vital sign".... The Joint Commission would come in and decertify hospitals based on how well they managed pain.
Did Pharma company’s make money on policies dictated by the feds... yea. But the Government of the United States drove the disaster.
Yes, I remember it was Joint Commission that also propagated using pain killers in the hospital. Now it’s opposite, patients are expected to tolerate some pain.
Before the 90s, opiate-type narcotics were given sparingly and for a limited time, except for chronic serious pain (cancer, orthopedic pain). A friend in college in the 80s was hospitalized for a few days with a kidney stone. He was given Percocet for the first two or three days, before the stone passed. Then he was switched to something else.
By the end of the 90s, someone like him would have been given Percocet for the hospital stay (which would have been shorter -- take note) and probably for a week or two afterward. In the 80s, the potential for addiction was far lower. By the end of the 90s, the durations (and sometimes the doses) were starting to push the edge of induced addiction. After the pain process is off the peak, narcotics can't be used up by the body sufficiently. The excess dose and time gets into the addiction zone.
Have been in hospitals where they wouldn’t treat pain over fear of the patient becoming addicted.. when patient was in severe pain, so I guess I’ve seen the other side as well.
Oh yea, we are back to the don't treat pain.... I do hospice and I have to jump through hoops to treat patients with terminal pain. Once again..... Government in action. Knee jerk action with no consequences. I hate to tell everybody but The Feds are inept.
Yes, this. Doctors couldn't understand why anyone would be willing to tolerate pain.
In 2002 I had to have a C-section to get my daughter out - she was upright and sideways. I had a spinal block for the surgery, and an hour or so later, when it began to wear off, a doctor came over to inform me that a nurse would come over to give me a shot of morphine. She didn't ask me if I wanted it, she just told me that I would get it.
I said that I didn't want any opioids, and that the pain was tolerable. The doctor tried to persuade me to get the shot, and I had to get emphatic in response.
Later that day, I got a visit from a psychiatrist who asked me pointed questions to see if I was into self-harm and if I would be a danger to myself or my daughter - ALL BECAUSE I DECLINED AN OPIOID PAINKILLER. In the end, the pain was moderate, and it prevented me from making any moves that could stress the sutures and prolong recovery.
Our daughter was born 8 weeks ago in what ended up being an emergency c section (emergency is either too light a word or too often used in medicine - probably the latter; wife and daughter were both minutes from dying). While it was probably headed that way, she really crashed not long after the epidural. For whatever reason, likely a combination of a scar from a prior back surgery as he anesthetist being off by half a millimeter, it went up and gave her a severe headache.
The anesthetist’s suggestion? “If she’s awhile from delivery, you can give her fentanyl.” My first thought? “MFer, FENTANYL!? How about we give from zero to ten, not zero to 100. Try advil or something first.”
Anyway, that’s the medical system. We love our doctors and hospital. That guy, though, was obviously from the Purdue era.
That is bonkers ALToronto! A psychiatrist, that is shocking. I'm glad you and the baby were both ok.
The coin has flipped for sure. I had a family member with a life threatening spinal cord injury 2 years ago who was actually driven temporarily mad by the pain. I've never seen anything like it and hope to never again. Numerous trips to the hospital ,one time they gave her 1 pill on a Saturday and said to follow up w the PCP on Monday. She got dismissed as a whiny old woman and told to meditate or whatever, until somebody actually looked at the imaging. Then they called a surgeon back from vacation to do an emergency surgery on her.
What a bunch of bullsh... What drove the opioid epidemic was the Federal Government. Starting in the late 80 early 90 pain management became a big deal. At that time Medicine was generally accused of not caring of patients were in pain. Nursing curriculum changed "pain as the 5th vital sign".... The Joint Commission would come in and decertify hospitals based on how well they managed pain.
Did Pharma company’s make money on policies dictated by the feds... yea. But the Government of the United States drove the disaster.
Yes, I remember it was Joint Commission that also propagated using pain killers in the hospital. Now it’s opposite, patients are expected to tolerate some pain.
Before the 90s, opiate-type narcotics were given sparingly and for a limited time, except for chronic serious pain (cancer, orthopedic pain). A friend in college in the 80s was hospitalized for a few days with a kidney stone. He was given Percocet for the first two or three days, before the stone passed. Then he was switched to something else.
By the end of the 90s, someone like him would have been given Percocet for the hospital stay (which would have been shorter -- take note) and probably for a week or two afterward. In the 80s, the potential for addiction was far lower. By the end of the 90s, the durations (and sometimes the doses) were starting to push the edge of induced addiction. After the pain process is off the peak, narcotics can't be used up by the body sufficiently. The excess dose and time gets into the addiction zone.
Wasn't there that pain chart with the faces?
That is for kids, non English speakers and people with cognitive issues. But I have seen it used many times in ER.
Have been in hospitals where they wouldn’t treat pain over fear of the patient becoming addicted.. when patient was in severe pain, so I guess I’ve seen the other side as well.
Oh yea, we are back to the don't treat pain.... I do hospice and I have to jump through hoops to treat patients with terminal pain. Once again..... Government in action. Knee jerk action with no consequences. I hate to tell everybody but The Feds are inept.
Yes, this. Doctors couldn't understand why anyone would be willing to tolerate pain.
In 2002 I had to have a C-section to get my daughter out - she was upright and sideways. I had a spinal block for the surgery, and an hour or so later, when it began to wear off, a doctor came over to inform me that a nurse would come over to give me a shot of morphine. She didn't ask me if I wanted it, she just told me that I would get it.
I said that I didn't want any opioids, and that the pain was tolerable. The doctor tried to persuade me to get the shot, and I had to get emphatic in response.
Later that day, I got a visit from a psychiatrist who asked me pointed questions to see if I was into self-harm and if I would be a danger to myself or my daughter - ALL BECAUSE I DECLINED AN OPIOID PAINKILLER. In the end, the pain was moderate, and it prevented me from making any moves that could stress the sutures and prolong recovery.
Our daughter was born 8 weeks ago in what ended up being an emergency c section (emergency is either too light a word or too often used in medicine - probably the latter; wife and daughter were both minutes from dying). While it was probably headed that way, she really crashed not long after the epidural. For whatever reason, likely a combination of a scar from a prior back surgery as he anesthetist being off by half a millimeter, it went up and gave her a severe headache.
The anesthetist’s suggestion? “If she’s awhile from delivery, you can give her fentanyl.” My first thought? “MFer, FENTANYL!? How about we give from zero to ten, not zero to 100. Try advil or something first.”
Anyway, that’s the medical system. We love our doctors and hospital. That guy, though, was obviously from the Purdue era.
That is bonkers ALToronto! A psychiatrist, that is shocking. I'm glad you and the baby were both ok.
The coin has flipped for sure. I had a family member with a life threatening spinal cord injury 2 years ago who was actually driven temporarily mad by the pain. I've never seen anything like it and hope to never again. Numerous trips to the hospital ,one time they gave her 1 pill on a Saturday and said to follow up w the PCP on Monday. She got dismissed as a whiny old woman and told to meditate or whatever, until somebody actually looked at the imaging. Then they called a surgeon back from vacation to do an emergency surgery on her.
EXACTLY! But it is always those with the deepest pockets who get blamed.
Last I heard the Government's pockets were black-hole deep. At least it seems to think so...