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Opioids for Chronic Pain & Questioning Pain Doctor vs. Drug Pusher

Pain specialist Ronald McIver is serving a 30 year sentence for drug trafficking. The drugs? Opioids prescribed for pain relief. NY Times Magazine looks into McIver’s case and the mess surrounding opioids for pain management.

The in-depth piece definitely supports the use of opioids for pain management. I’ve created a PDF of the article so I could highlight what jumped out at me. I didn’t highlight any details of McIver’s case.

I, too, believe that opioids should be available for people with chronic pain. However, the devil’s advocate in me jumped on a bunch of thoughts that I hope to explore this week:

  • Not feeling the body’s pain signals isn’t necessarily good.
  • The effects of long-term opioid use aren’t well known. Most research has been with cancer patients, who do not use the drugs for extended periods.
  • Building tolerance is not only your body getting use to the drug (called desensitization), but becoming more sensitive to pain overall, not just the pain that you are specifically treating.
  • When most patients (and some doctors) feel like they’ve tried
    everything, they haven’t. Often other treatments should be considered
    before turning to opioids.

Just reading this list may raise your ire. Please give me a chance to write about the topics before jumping down my throat. We’ll be able to have a more thorough discussion that way.

3 thoughts on “Opioids for Chronic Pain & Questioning Pain Doctor vs. Drug Pusher”

  1. I wept when I read that article. Dr. MacIver surely made some bad judgment calls, but I wondered, “Why isn’t this tried as a malpractice case?” long before the author got to that point.

    And I really wept when I read the extent of the problem of untreated pain.

    Could we perhaps agree, as a society, on the radical concept that Pain Is Bad? If you don’t think that’s radical, consider the signals we get from our social and religious traditions talk about character building and sanctified suffering and a lot of other fairy tales that we’re told as children so we will stop crying. But those are just that – fairy tales. I’m here to tell you that no, in fact, pain is bad.

    Thanks for sharing your thoughts. I agree wholeheartedly.


  2. No jumping down your throat here 😉 I look forward to reading more of your thoughts on this.

    I don’t like being on opiods, but they are the only thing that helps me function. After 12 yrs of CFS/FMS, and nearly 3 years of CDH, I’ve tried lots of things. I’m sure there are things I haven’t tried, but time/energy/money sometimes make choosing opiod meds my best option.

    I used to be afraid to do many things for fear of the pain after. While I still feel bad, at least I know my meds will take the edge off.

    Cases like this scare me to death. I’m so grateful my doc is not afraid to help ease my pain and trusts me to use the meds sensibly.

    Anyway, just my POV on this. I do agree in part with your points, but then again, I usually agree with your posts 😉

    Thanks for your thoughts. It’s terrific that opioids help you. I totally agree that they can be a great treatment for a lot of people. Mostly I think they are underused. But playing devil’s advocate got me thinking. . . .


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