Narcotics Are Overprescribed
Posted: February 9, 2013
Narcotics are more of a necessary evil, meant to be used under short, very controlled circumstances (hence the term controlled substance). However, for a multitude of reasons — patient “satisfaction,” expediency, or just plain practitioner fatigue — we will often go beyond the original intention of these very dangerous medications to placate the patient. (Photo by Associated Press )
We stop your son’s bleeding, reverse your daughter’s asthma attack, or sit bedside with your grandmother to explain what is happening as our emergency department team moves swiftly to alleviate what ails her. We do these things with professionalism and passion, our hearts swelling with pride as your young children “high-five” us on their way out the emergency room door, their wounds repaired, new stuffed animal gifts in hand, and smiles on your faces with the comforting knowledge that all is well.
Unfortunately, there is a dangerous, insidious, and growing blight on our abilities to do our best for you. It began as an innocent effort to help some, to make them happy, but has evolved into an unquenchable rampaging beast, which is tearing the system at its seams and putting your cherished ones at risk.
Part of what we as medical professionals do is relieve pain of all kinds through various means. One of the many tools in our disposal are narcotics- morphine, oxycodone, and the like.
Originally meant for relief of only the worst kinds of acute pain, such as broken bones, kidney stones, and severe trauma, they have now become so over-prescribed and pervasive in doctor’s practices that even the more routine lesser pain — the chronic conditions and problems that do not need to be solved with highly addictive and ultimately dangerous medications — are being treated with these medications.
By their very nature, narcotics are more of a necessary evil, meant to be used under short, very controlled circumstances (hence the term controlled substance). However, for a multitude of reasons — patient “satisfaction,” expediency, or just plain practitioner fatigue — we will often go beyond the original intention of these very dangerous medications to placate the patient, the system, or ourselves. In an environment in which government rates the quality of doctors on their patients’ visit satisfaction higher than the true quality of care received, the decision to relent to patient demands for addictive pain medicine becomes a doctor’s internal struggle between providing a temporary false sense of euphoric happiness with these poisons (and getting better satisfaction surveys) and “doing no harm.”
The problem has now reached epidemic and critical proportions. Hordes of narcotic addicts either overtly or under false pretenses are invading our emergency departments, crowding our waiting rooms, and overwhelming our EMS systems. They are siphoning our resources, sapping our energy, and stressing our practitioners and staffs. Sadly, we, as doctors are feeding the growing beast, creating a generation of patients who believe the daily use of pain pills are a normal way of life. Having just returned on a medical mission from Haiti, I am reminded how some in this world are grateful — and better off — with two aspirin and a glass of clean water.
So the next time you feel like you are sitting just a little too long in a waiting room for a doctor to see your little one’s broken wrist, or wondering why the ambulance has not yet arrived for your husband’s chest pain, think of the growing army of narcotics addicts that have hijacked our medical system and taken away from us the very thing that emergency workers are best at — doing right by the truly acutely ill and injured. You may weep, but I weep right alongside you.
Dr. Kramer has been an emergency physician at Rockingham Memorial Hospital since 1995.