Pain Treatment in the NYT

The most recent New York Times Magazine cover story (see here) concerns the prescription of opiods to treat pain.  The principal theme of the article is that there is sometimes a fine line between adequately treating a patient's pain and overprescribing medicines that are likely to be abused.  Here is an excerpt:

(Illustration by Suellen Parker for the NYT)

Identifying the scammers is especially tricky because there is no objective test for pain — it doesn’t show up on an X-ray. In one British study, half the respondents who complained of lower-back pain had normal M.R.I.’s. Conversely, a third of those with no pain showed disk degeneration on their M.R.I.’s. The study suggested there could be a profound disconnection between what an M.R.I. sees and what a patient feels.

There are red flags that indicate possible abuse or diversion: patients who drive long distances to see the doctor, or ask for specific drugs by name, or claim to need more and more of them. But people with real pain also occasionally do these things. The doctor’s dilemma is how to stop the diverters without condemning other patients to suffer unnecessarily, since a drug diverter and a legitimate patient can look very much alike. The dishonest prescriber and the honest one can also look alike. Society has a parallel dilemma: how to stop drug-dealing doctors without discouraging real ones and worsening America’s undertreatment of pain.

In this article draft, I discuss some promising technologies that may someday make our pain measurements more objective, along with some of the neuroethics-related issues the technology may raise along the way.

Comments

[michael jones]

Interesting information! I hope that this back pain cure will be able to help soon!