Addressing the health care system flaws that feed the opioid crisis

I’m an ED physician, so I’m used to patients screaming at me — sometimes with earsplitting demands for heavy-duty painkillers, morphine drips and similar remedies that will numb or “fix” them. I can deal with this. What I can’t deal with is a health system that incentivizes physicians like me to medicate adult patients, especially those at high risk for substance abuse, with little thought given to their long-term wellbeing. As I write this, a recent incident comes to mind: Earlier this year, a regular heroin user experiencing a medical crisis entered my ED. After going over his medical history, I tried to express how worried I was about him and how we needed to treat him, but he said all he wanted was IV opioids. I talked at length about non-opioid alternatives, but he said opioids were the only thing that would help. At one point he actually screamed, “I know there’s a sign on this wall that says you need to do everything for my pain!” I explained to him as politely as possible that the law only requires me to medically screen and stabilize him, not medicate his pain, although I was happy to address his pain. He was furious — and ended up threatening all of us, pulling out his IV (and covering the room with blood) and storming out of the ED. That kind of reaction isn’t uncommon, and quite frankly, I was glad none of the staff were injured. The opioid epidemic is so out of hand that physicians and nurses are sometimes attacked by patients who are enrage...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Emergency Medicine Pain Management Source Type: blogs