Are Doctors profiling patients and denying pain medications

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patient profiled by doctor
Patient: Doctor, it hurts when I do this!
Doctor: Then don’t do that!

This is a very famous joke that originated with the comedy team of Smith and Dale in the early 20th century, and later made more famous by the comedian Henny Youngman. The idea behind it is that patients sometimes do stupid and harmful things (for example, smokers continue to smoke even after being told that they have a great chance of developing lung cancer) and that doctors look out for the best interests of the patient. In theory, this is not always the case. In practice, doctors sometimes do more harm than good.

Doctors can harm patients needing pain medication in one of two ways. The first way is to (perhaps not) profile the patient and to provide them pain medication. A study in California showed that 3% of the doctors prescribed 62% of the painkillers. This helps to perpetuate addiction to painkillers.

Nicole Richie, Winona Ryder, Matthew Perry, Kelly and Jack Osbourne, Jamie Lee Curtis, Eminem, Courtney Love, Charlie Sheen, Rush Limbaugh and Chevy Chase are some of the celebrities who are or have been addicted to painkillers. The economic costs of the non-medical use of prescription painkillers is $72.5billion every year, or about $200million each and every day, or about $0.64 from each and every man, woman and child in the United States for each and every day in the year.

In 2010, there were 16,651 deaths (or almost 46 deaths each and every day) that involved overdoses of prescription painkillers in the United States, according to the Center for Disease Control. Philip Seymour Hoffman, Anna Nicole Smith, Bruce Lee, Chris Penn, Elvis Presley, Heath Ledger, Frida Kahlo, Brittany Murphy, Dana Plato, Corey Haim, and Michael Jackson are just some of the famous people who died as a result of painkiller medications.

The second way that doctors can harm patients is to profile the patient and to deny them pain medication. This is a two-fold problem.

doctor denying medication cartoon

The first problem regards profiling itself is who is being profiled. After 9/11, many Muslims and anybody who resembled what was thought to be Islamic (which included many Sikhs) were harassed, beaten or killed in the United States. These things were done because it was known that people who happened to be Muslims hijacked the planes that resulted in thousands of deaths. People who happened to eat and to wear clothes were also responsible for hijacking the planes, but these people were not subsequently targeted for supposed retribution.

Typical Profiling Scenario

Medical professionals say profiling is done for predictive value, especially in regards to the dispensation of pain medicine. A few providers refuse to provide pain medicine unless the patient meets these requirements:

  1. Age: 27 years and older
  2. Pain must have continuous pain for 4 months or more
  3. Verification of a severe physiological problem through a CT or MRI scan
  4. The pain sufferer must agree to pursue other therapies such as diet and exercise, and mental health therapies
  5. The completion and verification of a 25 page document regarding the patient’s intake, and which also includes his or her psychological and arrest history.
  6. The agreement to regular drug testing, including the signing of disclaimers and of contracts
  7. A reassessment every 30 days of the patient’s pain situation.

Now how is chronic pain at the age of 26 years 11 months irrelevant, but the same pain one month later is suddenly appropriate?  I know that if I were a chronic pain sufferer then I would not want medication withheld because of equally flimsy legal reasoning. Also, how is the health care provider going to obtain histories of arrests and of psychological concerns of the patient? This is indeed very scary and should override anything else.

And are these requests for information truly predictive? If I take a hammer and smash it against your hand then you will have several broken bones. There is an objective, rational and causal relationship between the swinging of the hammer and your broken bones. Is there also an objective, rational and causal connection between these requests for information and the accurate denial of pain medication only to those who do not truly need it? I have yet to find any study, independent or otherwise, that states that profiling is a 100% accurate way of providing pain medication only to those who truly need it.

This patient profiling will increase in the United States. 16 years after the defeat of Nazi Germany, Yale University psychologist Stanley Milgram conducted an experiment to discover whether or not Americans had the same capacity of blind obedience to authority. He found that about two-thirds of the people were obedient throughout the experiment. This experiment, called the Milgram Experiment has been replicated throughout the world and throughout the intervening years, always with similar results. So if people are the same then why are they treated differently? That is the true problem associated with profiling.

Denial of pain medication is almost inhumane in my opinion, pain is well painful, but chronic constant pain causes suffering and makes life difficult. My wife suffers from arthritis in her knee. She suffers not from the arthritis itself but from the pain resulting from arthritis. Fortunately, she is taking several treatments that help to minimize and remove much of the pain. Others, however, are not so lucky. Others have continuous pain, and pain in places that can not be as easily attributable to a certain cause.

Are cops forcing doctors to withhold medications?

Harvard based physician, Dr Fisher says that chronic pain is an under-treated condition in the US and that law enforcement officials are pressuring medical practitioners to literally withhold pain medications. Aggressive law enforcement officials are forcing doctors to under-prescribe pain medications as they now fear prosecution. So are doctor’s medical judgements over-ruled by police?[/vc_column_text][pull_quote_center]”What we’re dealing with is a mass insanity,” says Dr Fisher. “We call it the war on drugs.”[/pull_quote_center]

[cleveryoutube video=”HTJPraJZwno” vidstyle=”1″ pic=”” afterpic=”” width=”” quality=”inherit” starttime=”” endtime=”” caption=”” showexpander=”off” alignment=”left” newser=”Cops playing doctors?”]

The video above shows Seán Clarke-Redmond, a man suffering from Lou Gerig’s disease, a neurodegenerative disease that made him almost immobile and in constant shearing pain. Redmond says he wants to die as he can no longer endure the severe constant pain made worse by doctors who are under-prescribing pain medications.

Stories of celebrity addicts who have allegedly abused prescription drugs has got the Govt in an over-drive mode and many politicians and administrators are calling for even stricter monitoring of doctor-patient relationships. This is unfortunate and something that is not going to go away anytime soon.

I personally feel at the very least the non-psychotropic medicines like Viagra should be more freely available. No wonder there are scores of men scouting forums with where can I buy Viagra type questions.

Case Studies

A heavily tattooed Jay Snider suffered greatly from a horrible 10 foot fall. His girlfriend had a slight cut on her finger which required two stitches, from another incident. The doctor had given pain medication to her but refused to prescribe it to him. Mr. Snider legitimately feels that his appearance, not anything else, caused the denial of what he objectively needed.

Mr. Carl Williams injured his back at work and, because of the pressures and need for work, he could not take time off from it. To accomplish everything that he needed to do, he sought and was given pain medications. He took the prescribed amount for two years, returning every six months for a renewal of the proper subscription. He tried to find ways to minimize this need by seeking out alternatives. He was then considered to be a drug addict by the doctor, and told to look for another doctor, making things more worrisome for him. Objectively, he took steps to limit his dependence on the medication, and yet he was declared a drug addict; this seems to be a contradiction in terms, coming from the doctor.

The profiled present

Why is any or all of this happening? Perhaps it is because of society and time itself. Decades ago, there was no all-encompassing War on Drugs which is now, more obviously, the War on Patients or the War on Illegal Drugs (although if drugs, intrinsically, are a bad thing then legality and illegality should be irrelevant).  Decades ago, doctors saw patients individually and prescribed medicines and managed side effects and addiction, people were not needlessly profiled, they were given the medications that they needed, and they survived. Why can we not return to some semblance of that process?

If it ain’t broke don’t fix it. I am sure that Henny Youngman would agree.