One of the things about pain is that it’s totally subjective.
You can run all sorts of diagnostic tests and tell your patient that all the results are normal, but you CANNOT tell them they aren’t in pain, when clearly they are.
People react differently to analgaesics, and for some people narcotics are their only real option. It would be a pity to deny someone with chronic idiopathic pain the chance of relief because we don’t like the drugs they need to take.
I could, but if you are dealing with an addiction, you need to stay open to new ideas and change old patterns. I know from personal experience. Besides, there’s no use getting into a pissing contest with a skunk. 
But yes, people die from alcohol and barbiturate withdrawal. Here’s a link by a reputable source discussing how to avoid death while withdrawing a patient from barbs: http://www.mentalhealth.com/rx/p23-sb10.html
It would also be a pity to avoid discovering a patient who somatosizes all his emotional and spiritual turmoil into physical pain, and just cover his symptoms with narcotics.
Once chronic undefined pain patients have been detoxed and guided to address those sorts of issues, many have discovered they no longer have a need for narcotic analgesics.
There are no easy solutions, but the number of people with genuine chronic pain of unknown origin which cannot be helped by many modalities other than opiates is really small. Not zero, but small.
I know. I was more or less joking. Since it happened weeks ago, I’d probably look a bit obsessive and petty if I went in with a citation. The problem is, it’s hard sometimes. I, like most Dopers, am skeptical by nature and whenever I question or challenge any of her ideas, “defense mechanisms” is often her retort. I sincerely try to keep an open mind and she usually makes note of this at the end of our session.
:rolleyes: :rolleyes: :rolleyes:
Tell her she’s saying that because she’s afraid to admit that she’s envious of your penis.
Informed consent? What is this infomed consent you speak of?
Yeah, I was that way too! I would argue any point to death, and think that showed I was right about everything, since I was right about that! But early recovery is the time to listen, and ponder, and learn from lots of different people. And change.
I’m much better now, thanks.
Thanks for the info and advice, Doc. I’m glad it worked out for you. 
I read in the paper not too long ago of a study which showed that some people were naturally more sensative to pain than others. The study included brain scans of people experiencing painful stimuli, and in those people who said that they were in a lot of pain, their brain scans showed more activity than in those folks who said they weren’t in much pain. Once again, medical science discovers what we already knew.
[hijack]
QtM, in the time since your treatment for your addiction, have you noticed that pain meds don’t work for very long when you need to take them? I’m asking, because I used to use a lot of drugs (never was an addict, though) I’ve found that all pain meds wear off quite rapidly on me. Whenever I go to the dentist, I have to have lots of pain meds and the doctor only has a short window of time to work, because almost exactly an hour after he gives me the injections (he’s quit using novocaine and switched to another kind of “caine,” but I don’t recall what it is) it’s completely worn off.[/hijack]
sorry, tuckerfan, I noticed nothing like that. I’ve had strong narcotic pain meds given for cardiac pain, and they did nothing but treat the pain (which is what they’re supposed to do, after all!). But anesthetics work fine for me.
I’ve taken care of a lot of recovering addicts as patients, and not heard any consistant reports of analgesics or anesthetics not working for them.
Hmm. Wonder why I’m so “lucky” in being able to metabolize pain meds so fast?