Managing chronic pain is becoming increasingly difficult. As Dr. Rob observes, many primary care doctors simply don’t prescribe narcotic medications.
Worse, pain specialists often won’t either, preferring to focus on procedures and non-narcotic management:
What happens when, despite my best efforts, the person is still in significant pain? Most of the time I get to an impasse like this, I send the patient to a specialist. The job of the specialist is to take care of those cases that are too difficult for me to handle. But in the case of chronic pain, there is a problem: most of the pain specialists in our town don’t prescribe any narcotics. None at all. They offer procedures and non-narcotic medications, but won’t cross the line and give pain medications.
There are multiple reasons for this, including fear of DEA prosecution, risk of a “drug-seeking” patient population, and the fact that procedures for pain pay better.
But where does that leave the patient, as well as the primary care physician who’s left to treat chronic pain without any consultant backup?
