The Painful Treatment of Pain

I've been following recent discussions in the general press about the treatment of pain. The withdrawal of Vioxx has focused public attention on the FDA and on the subject of pain. Most people are well acquainted with acute pain but fewer suffer with chronic pain and thus the uninitiated often cannot comprehend why anyone would risk significant illness to gain pain relief. Even many physicians question the need for the use of narcotics in the treatment of chronic pain. I read one article where a physician said that the use of Vioxx might be warranted after the patient had 3 or more weeks of severe pain but the med should only be used until the patient had some relief and then it should be discontinued- spoken like a person who has no idea what it's like to have 3 weeks of severe pain! Perhaps the severely dehydrated patient can have water but once he makes urine again he should be cut off from the liquid that restored him. This type of thinking is not logical.
Chronic pain is a significant medical problem that invades and erodes all aspects of a person's life. It makes sleep difficult, diminishes enjoyment of food and company, intrudes on mental activities, stresses the body. Before I started Neurotin I tried to used meditation or mental activity to keep my pain in check. At times I would consider whether chopping off a foot or hand would lessen my pain by 25% or if the remaining 3 body parts would just hurt that much more. When my pain got to a 5 or 6 I would get into a very hot tub and stay there until I risked drowning. My pain would clear using this method but probably at the expense of brain cells that were injured by vasodilitation induced hypotension. When I started having pain at an 8 level I caved in and asked for a prescription for Tylenol #3. At first I was very cautious about its use but now I'm more liberal. If I have breakthrough pain that doesn't respond to heat, massage or rest then I'll take a Tylenol #3 rather than suffer needlessly.
The operative word being needlessly. Sometimes we need to put up with suffering to reach a greater goal- vaccines are a good example of that principle. But many times people are asked to suffer for no apparent reason other than that the person (or people) doing the asking is not willing to help eliminate the cause of the pain or effectively treat it. One of the tasks physicians are charged with is the relief of suffering yet many docs have been frightened away from the use of prescription pain meds by medical boards more interested in preventing narcotic abuse than lessening pain in the ill and injured. Physicians need to practice reasonable care in writing for any pain medication but should not let fear become part of the equation when treating pain. When that happens we all suffer.