Doctors Who Won't "Treat" Pain
Robert Filice, M.D.

A recent issue of AARP's magazine has an article about the reluctance of many doctors to "treat" pain with adequate doses of strong enough pain relieving drugs. This is based on their concern about reprisals from the DEA or the state licensing boards. The author, Barry Yeoman, refers to  Americans suffering without adequate medication as being "Prisoners of Pain", and speaks of the millions of people being denied the prescription drug relief they need. He is especially referring to the use of the opiate class of analgesic drugs. Considering that 75 million Americans are suffering from chronic pain, undertreatment or inappropriate treatment should indeed be of major concern to us.

According to orthodox medical experts like Scott Fisher, the president of The American Academy of Pain Medicine, who ARE comfortable prescribing these drugs, much of this suffering is preventable. According to him, opiate class drugs are relatively safe and effective, and should be used much more widely by physicians.

Apparently a few cases of doctors being arrested by DEA agents for overuse of these drugs has left many physicians avoiding the subject completely. They try to ignore patient complaints of chronic severe pain because they are unwilling to risk prescribing the only effective class of painkillers for severe pain, the opiate narcotics. Interestingly, one specialist complained that there was a pervasive "just say no to drugs" philosophy in this country, and even his own family advised him they didn't want to be "doped up on those drugs".      

I must say, as usual, my perspective is far different. There are some very advanced terminal cancer patients for whom I can accept the use of these drugs. However, in general, the addition of narcotics to a cancer patient's drug regimen is almost always associated with a more rapid downhill course and more misery from faster spread of the cancer itself.  The immune suppression effects of these drugs have been well established. What about the issue of addiction and tolerance? Physical addiction is likely with these drugs. According to the proponents that is not a problem. Yet the law of diminishing returns applies in these cases. Higher and higher doses have less and less effect against the pain.

In some cases there is also the phenomenon of rebound pain, whereby the wearing off of the drug brings on an exaggerated level of pain which calls for more drug and a negative vicious circle of narcotic use.

This whole scenario was called to mind as a result of the case history of a new friend of mine. He told me how his excruciating back pain from two completely blown out lumbar disks lead to surgery, and then to a life of increasing dependency on Vicodin, a narcotic analgesic not even as strong as the opiates endorsed by the experts in the AARP article.

He was eventually taking huge doses daily, and would wake up with awful pain. Soon the medication seemed to be only marginally effective against the pain, and he became depressed. He basically did not want to live any more.  An antidepressant medication did help him with the depression (unusual for that type of depression), but he told me that if I had advised him to get off the pain medication at that time he definitely would have found another doctor.  Eventually his pain got so bad even on all those meds that he himself decided  he would stop the drugs. That began a month of sheer tortuous physical and mental anguish, but the end result was that he got his life back. His pain diminished greatly and his depression cleared, and he got off the antidepressant. I share this because my friend told me to use his story to help other people that might be suffering from opiate pain killer dependency and the rebound pain phenomenon. He offered to talk to anyone who may be where he was when he wouldn't consider that his pain medication was ruining his life. Just let us know you want to talk to him, and I'll have him give you a call.

The physicians here at Caring Medical, who to a great degree specialize in the treatment of chronic pain, will not prescribe narcotic or opiate drugs for pain relief.

The reason has nothing to do with the DEA or the state licensing board, and everything to do with our care and concern for the whole patient. Narcotics are bad news for patients. A narcotic pain killer never made the underlying condition any better.  But we don't ignore patient complaints of pain like some doctors are doing. A large number of those 75 million Americans in pain are suffering from conditions that can be reversed with Prolotherapy. Prolotherapy stimulates the body to permanently heal damaged and hurting tissue, so that our musculoskeletal pain patients usually get off of all their anti-inflammatory and pain medication by the end of their treatment. It is a much different world here. A better world for the patient suffering from chronic pain.