Pain is the most common reason for emergency room visits and lost days of work. It’s also one of the greatest causes of disability.
Approximately 100 million Americans suffer from chronic pain. That’s more than cancer, diabetes, and heart disease combined.
The stimulation and relief of pain can change a person’s behavior and perception of the world. It is a very costly public health problem, costing more than half a billion dollars in health care expenditure annually.
However, pain can also be beneficial; it draws attention to injuries and potentially dangerous medical conditions and leads people to seek medical care for serious physical problems.
A large majority of patients in our emergency rooms complain of pain. Most of them are given an IV Dilaudid "push." The patient receives two or more doses of this medication while in the ER, and it works well. The pain goes away and the patient feels better.
The patient then gets admitted to the hospital and the Dilaudid medication is continued, usually every three hours. When they are discharged, they are typically prescribed a 10-day supply of Percocet.
The patient goes home, the pain gets worse and they either go back to the ER, to urgent care, or to their primary care physicians.
These patients then get prescribed more and stronger opioid pain medications. They are now coping with a dependency created by the drugs prescribed to them and it is not their fault. They are what I call the “accidental addict.”
And they really need help — both with their pain and with their addiction.
Addiction is a very real problem and treatment is very complex. In 2012, more than 12 million Americans reported using prescription painkillers for nonmedical reasons. Prescription painkiller overdoses were responsible for more than 15,500 deaths in 2009 — more than the total for cocaine and heroin.
That number is four times greater than in 1999.
By creating accidental addicts, hospitals have created a generation of opioid-dependent people.
Emergency rooms and others who treat pain need to change the way they do business so we can start to put an end to tragic overdoses and lives destroyed by substance abuse.
Posts by Melanie Rosenblatt, M.D.
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