By Dr. Jeffrey Grolig.
No involuntary tapers! It has become a slogan of The Physician Primer, a medical-legal practice guide for physicians.
I have treated chronic pain for the past 35 years, and I’ve seen it all. From blue collar workers with failed spine surgeries, to housewives sidelined by fibromyalgia, to executives whose careers ended with a car accident. My journey witnessed remarkable success stories and
“cures” on the high end to suicide and homicide at the bottom.
At the same time, I’ve watched the doctors at their extremes. I watched as the Harvard graduate made headlines by arrogantly defying law enforcement only to make the six o’clock news with his arrest the next night. He languished in jail for over two years until a kind-hearted lawyer rescued him pro bono. Recently I’ve witnessed a slew of colleagues lose their licenses to documenting technicalities.
The net result has been a Perfect Storm of fear and suffering; doctors who are afraid to prescribe any opioid, not even the smallest amount to the most deserving case. And today, I see too many suffering pain patients who can’t get a doctor to save their life.
I am not an opioid proponent. Never have been. My training specialized me in Physical Medicine & Rehabilitation. We treat the whole person, and if that means some opioid with counseling and P.T., that’s what the patient gets. I am neither an opioid guy or an injection guy.
I am a what’s-best-for-the-patient guy.
But today, everyone is polarized. The addiction specialists detest opioids and overdoses, but are ok with suffering and suicides. The opioid docs remain staunch opponents to the addiction specialists. The government wants anything that will save money-and now that means Medicare opioid ceilings. The police, DEA and medical licensing boards take their cues from the government.
But where does all this leave the suffering pain patients? To eliminate fear, we need education, not just a little, but a great deal. I studied addiction, and I became a lawyer. But I still practice medicine in my day job. I know a lot about opposing viewpoints.
Every physician who treats pain or prescribes opioids should read my Physician Primer: Prescribe Like a Lawyer. They don’t have to be afraid of prescribing opioids if they understand the laws and how law enforcement operates. I advocate no involuntary tapers. Every one of my pain patients has read The Pain Patient Handbook. I can’t tell you how many of them asked for tapers after they read it.
With education of both patients and doctors, we can eliminate both fear and suffering. No More Involuntary Tapers!
Dr. Grolig is a board-certified specialist in Physical Medicine and Rehabilitation. He has taught in both the departments of Family Practice and PM&R at U.C. Davis Medical Center. He has worked as a practicing attorney. He founded and directed the first Multidisciplinary Functional Restoration Program in Northern California in 1991. He has authored six books.