Good pain physicians are dying. Just a few weeks ago Dr Todd Graham was shot dead in a parking lot over refusing to prescribe opioids to a man’s wife. Physicians who care deeply and try to do the right thing are being murdered for not prescribing opioids.
I prescribe very few opioids in my chronic pain practice. I do so in a judicious and safe manner for my patients. I have excellent training and I care deeply about the health and welfare of each and every one of my patients. Why is it that I as a double board certified pain physician have to consider whether or not I should have a firearm in my office to protect myself or my staff? Should I carry one at home in the event someone tries to find me or my children? It is easy to think “wow, this lady needs some Zoloft and a few counseling sessions.” I’m here to tell you that I do not know any pain physicians who have not been threatened in one way or another over the prescribing or not prescribing of opioid medications.
“Well, I will have to turn to heroin.”
“If you don’t fill my prescription I will find you…..” and even
Its unnerving to say the least. I had a mentor in fellowship who was truly stalked over opioids. The man followed her for six months. Sat outside her house. Followed her to work. Watched as she picked up her daughter from school. This is a real and serious concern for the practicing pain physicians in this country. Where is the happy medium here? Where is the patient responsibility? What is wrong with our society that this is becoming the norm?
I worry every day. I worry about the ramifications of not prescribing opioids. I look over my shoulder when I walk to my car. If I’m forced to terminate a patient for violations of their opioid contract I consider whether I should put a handgun in my purse for a few weeks. But it doesn’t end there. I worry about the ramifications of prescribing opioids. I worry about a 2am phone call from the authorities saying that my name is on the bottle. I worry about the DEA showing up in my office unannounced.
I would like to suggest that the root of this opioid epidemic lies far deeper than “physicians overprescribing”. The problem is that we are now a society of adults who have no coping skills. No ability to deal with the curves that life throws us. Everyone is looking for a quick fix. We have taught our children that they should never have to feel any sort of discomfort whether emotional or physical. When pain or suffering occurs, there is a quick fix for it and it is the responsibility of someone else to provide that fix. Opioids certainly treat physical pain, but they simultaneously provide a temporary solution for things like emotional pain, sadness, and anxiety. The reward system inherent in our neurological setup provides the anxious and depressed patient a temporary euphoria when taking the drug. I would argue that a large portion of what we are truly treating with chronic opioid therapy is psychological. Suffering is a part of life. Until we as a society learn how to be present with negative emotions and to effectively deal with and process the things life brings our way we cannot and will not solve this crisis. Sure, we may prescribe less opioids but people will turn to other substances, good physicians will continue to be murdered, and I and my colleagues will continue to look over our shoulders.