What happened to the days when doctors and patients had trust in each other? Did it end when the DEA entered the exam room and doctors became afraid to prescribe what they wanted to? What they believed their patients needed?
There are some doctors who have gone to jail or had their licenses or prescription writing privileges revoked because they were doing what their Hippocratic oath required of them (to help).
Others, though, have gone to prison, and lost their licenses and writing privileges because they over-prescribed to the point of illegal behavior.
An opioid contract does not make the doctor promise to behave legally.
Many pain patients are asked to sign a form that includes promises such as “I will not use illegal drugs while being prescribed medications by my pain doctor”. They agree to “random test drugging when I come for appointments”.
If and when I am asked to sign such a contract I am being presumed a felon. Even the American judicial system assumes innocence until proven guilty. Why is this not true with the pain doctor-pain patient relationship?
Can such a lack of trust and faith go hand in hand with good medical practice?
I posit it cannot.
Most pain patients do not get addicted or abuse their drugs. This is a continuation of the false impression given by the media that pain patients like their meds, how it makes them feel, and easily becoming addicted or dependent. They say there is an “epidemic” of abuse and overdose deaths.
But the so-called epidemic is allowing the government to abuse us by inserting themselves into the exam room.
I have no problem with a pain contract. But a contract requires a promise by both sides: I will do A and you in return will do B.
Pain contracts are one sided. The patient promises not to do things, including illegal behavior. In return, the doctor will continue to see you and behave like a doctor. But that contract is already in play when you see the physician. He always has the right to terminate you as a patient. He is already bound by oath and license to behave like a doctor.
A legitimate contract would require the doctor to behave in certain specific ways: “I will trust my patient to behave in a legal and sensible manner absent proof to the contrary. I will work with my patient to make sure they have adequate pain control.” And so on.
It is not a legitimate contract when only one side is required to make promises.
If a physician can make it through medical school and residency he most probably has the intelligence and ability to discern when he is being played. Yes, he may be misled by a patient or two, but that is true of any medical practice.
You cannot always differentiate between the false complaints of a malingerer, hypochondriac, or con artist and real pain symptoms. Yet no other specialty requests that the patient promise “I will not engage in felonious behavior”.
Chronic pain patients should not treated with suspicion. We should be treated like any other patients, with trust and belief, until and unless our behavior indicates otherwise.
Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 30 years. She is the author of “A Pained Life, A Chronic Pain Journey.” Carol was accredited to the United Nations Convention on the Rights of Persons with Disabilities, where she helped get chronic pain recognized as a disease.
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represents the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.