Physicians: The Modern Day Drug Dealers
26,000 physicians across the United States fuel the country’s opioid crisis
Overprescribing by 50%
The US is projected to have 700,000 opioid deaths by 2025. Doctors are misprespcribing pain killers because of the subjectivity of current pain assessments.
Pain is the focal reason people enter the healthcare system. It’s also a private, subjective experience that’s difficult to communicate. Doctors have primarily assessed pain by asking patients to rate pain intensity on a numerical scale and describe how it feels in words.
Example: Patients walk into the doctors office and the first question they are asked is — “what is your pain level on a scale of 0–10. 0 being no pain at all and 10 being I need to go to the emergency room.”
But, these methods don’t work very well for most patients. The intention of pain scales is a rapid proxy to understand the intensity of pain. These scales don’t yield any objective meaning because they are influenced by several factors: patient threshold for pain, whether or not their response of a digit matters to care, what number will yield medication so they can recover. Additionally, the scale confuses patients. How are they supposed to take a complex internal experience that manifests in pain and scale it down to a single number?
Some doctors are stating that “Younger children just tend to choose the smiley face because they like it,” Williams says, “even when they have a lot of pain.”
Research done last year supports the idea that scales aren’t a reliable way to measure change in pain. In a conversation with Dr. Charles Jonassaint, he said: “I have some patients, who, when they’re in the hospital getting pain treatment, I’ll ask, ‘What’s your pain?’ and they’ll say, ‘Oh, it’s an eight,’ and then after another dose of pain treatment, they’ll still say it’s an eight, and we almost get into a process of these pain ratings becoming automatic.”
Second, doctors often ask patients to describe how their pain feels. Pain language was systematized in 1970 with the introduction of the McGill Pain Questionnaire, but research suggests that words like dull, sharp, splitting, lacerating and throbbing aren’t helpful. In one 1992 study, patients tried to match different types of pain with the most appropriate adjective, and chose an average of 10 types of pain per…