Pain practitioners are pulled in many directions.
-First our obligation
is to care for our patients TO THE BEST OF OUR ABLITY, give them a
medically sound and scientific
treatment. Unfortunately pain is closely linked to emotions. Plus a
significant amount of medications for pain relief also stimulate our pleasure,
gratification and addictive centers. This generates a secondary effect on the
patients using opioid pain medications. Their pleasure/addictive centers get
stimulated by the opioids creating a craving for more. This makes the situation
difficult because patients are blurred into using more and more opioids, in the
name of still having PAIN. It has only been recently that we have been
able to clearly understand this conflict unfortunately at the expense of having
created many iatrogenic (medical) addicts.
-Then, we are monitored by the DEA (drug enforcement
administration) with rules and regulations that we prescribers HAVE to
follow. An important group of our
available pain medications (opioids) are not only very powerful in diminishing
pain but also very addictive and craved by users, so needles to say very
lucrative in the black market. This creates a tense environment between
prescribers and their pain patients.
-Also insurance companies are directly targeting pain
practices. They are cutting re-imbursement for needed procedures, visits, tests
and refusing to pay for a lot of the safer medications that we consider more
effective and appropriate.