Pain, Compassion, Addiction, Malingering
How to use opioids and how to not use opioids
Video + Slides (University of Toronto) (35 minutes + questions)
SMACC 2015 Audio (right click to download) (25 minutes)
EM Cases Discussion with Anton Helman and David Juurlink
Opioid Misuse Phraseology
My job is to manage your pain at the same time that I manage the potential for some pain medications to harm you.
I know you are in pain and I want to improve your pain, but I believe that opioids are not only the wrong treatment for your pain, but that opioids are the cause of your pain. I think pain medications are harming you, and if you could stop taking them, your pain and your life would improve. Can I offer you resources that will help you stop taking pain medications?
Prescription pain medications, even when used as directed, can cause patients to become dependent, and I’m concerned that the pills we prescribed for you in the past, even though you were using them appropriately, you may now be dependent on them. We can help you break free of that dependence.
My most important job as an emergency doctor is to make sure there’s no emergency, so I would like to do some tests to make sure there’s nothing dangerous happening to you, and also I want to relieve your pain. But you will not receive any opioids while you are here, because I think opioids could be harmful to you.
Here is your prescription. I am not entirely comfortable giving you this prescription because I am concerned that you are being harmed by these pain killers. When you decide that you want to stop using these drugs, and I hope you do, we can help you. Here is a list of resources available to help you stop.
John Oliver’s stunningly comprehensive, dead on accurate, often hilarious take: (20 minutes)