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Tuesday, December 20, 2016

“What kind of childhood is that?” Orphaned by an opioid epidemic

Pain free vs. discomfort free. The opioid epidemic is in no small part fostered by pharmaceutical companies and doctors with good intentions. Over time we have even labeled pain as the "fifth vital sign" and engaged in an aggressive campaign to eliminate it. Pain is even a part of the hospital's patient satisfaction survey-"how often did the hospital staff do everything they could to help you with your pain?" Seems a patient centered question, right? But, is pain free achievable? Is it even safe to target pain-free? And, how does one differentiate appropriate discomfort due to an ailment or medical intervention from pain? Should the hospital staff really do everything they can even to your detriment in other areas-dependency, respiratory depression, toxicity, delirium? How does one answer this question after the fact without knowing if your doctor was faced with balancing such risks? In may ways we have become a society which expects to be discomfort free--free from melancholy, free from anxiety, free from aches, free from remorse, free from uncomfortable obligations, etc. Are such expectations truly realistic? What is the price to pay?
from Rajesh Harrykissoon, MD

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