The use of opioids has created a crisis for much of the U.S., but these drugs are often used by doctors as painkillers.

Credit: John Moore

Mass. General Doctor Explains The Culture Of Pain Management

March 2, 2017

Roughly 2,000 people died from opioid overdoses in Massachusetts last year. That's more than double the number of overdose deaths from just four years ago. With overdoses on the rise, community members, including healthcare workers, are looking for ways to stem the opioid epidemic.

Boston's Massachusetts General Hospital is one of the hospitals in the area that is rethinking their policies on prescribing opioids to manage patient pain.

Dr. Sarah Wakeman is a primary care physician at MGH and co-chair of the hospital's opioid task force. She spoke with host Barbara Howard about alternatives to opioids when it comes to pain management.

Some of the main points Dr. Wakeman touched on were whether hospitals typically screen for a history of addiction before prescribing opioids, and whether there's a need for a culture shift in seeing opioids as the go-to drug for pain.

"Many hospitals still don't screen for substance use universally," Wakeman said. "Mass. General — actually several years ago — began screening all inpatients for alcohol and drug use."

She also discussed the cultural differences between the U.S. and other countries when it comes to pain medication. For instance, in countries around Europe, the go-to medication to treat pain after surgery is Tylenol, whereas here, doctors immediately opt for opioids to kill pain.

"I think we need to reeducate patients that we're not going to be able to get pain to go away entirely, that we want to be treating people with compassion and managing their pain as best they can," Wakeman said. "But, we need to always be weighing the risks and benefits of a given therapy and really starting with less intensive therapies first and really only escalating for people who really need more aggressive pain relief." 

Wakeman added that aggressively treating pain is a priority for doctors because if patients report still being in pain upon their release from the hospital, it could negatively affect a hospital's reputation and finances.

"Patients are surveyed after they leave the hospital," Wakeman said. "They're asked about how well their pain was controlled during their hospital stay, so that becomes one of the measures that hospitals are rated on and it's linked to reimbursement in some cases." 

To listen to the entire interview with Dr. Wakeman, click on the audio player above.


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