15 March 2016
The federal government wants you to feel your pain
The Centers for Disease Control just issued new guidelines for prescribing opioid painkillers. First try ibuprofen. Then if you’re still screaming in agony, take a urine test to prove you’re not an addict, give your physician time to run your name past your state’s pill police — and maybe, just maybe, you’ll obtain a three-day prescription for a low dose of an opioid painkiller.
The guidelines recommend what many addiction experts have long called for — that doctors first try ibuprofen and aspirin to treat pain, and that opioid treatment for short-term pain last for three days, and rarely longer than seven. That is far less than current practice, in which patients are often given two weeks or a month worth of pills.
The guidelines are meant for primary care doctors, who prescribe about half of all opioids but often have little training in how to use them. They call for patients to be urine tested before getting prescriptions and for doctors to check prescription drug tracking systems to make sure patients are not secretly getting medicine somewhere else.
Will this draconian, guilty until proven innocent, approach reduce the number of people who die from overdoses of prescription painkillers? Perhaps. But I have my doubts. And why should good people suffer pain that can be treated just to keep bad people from dying from their own recklessness?
Anti-drug addiction zealotry is behind the new guidelines. The zealots mean well, but their cure for what obsesses them is mean, mean as hell. And they’re not the only members of the opioids are bad fraternity. Their partners are the religious zealots who believe that suffering builds character. There are, wrote Mark Kleiman:
…two different approaches to dealing with suffering: the religious view that accepts it as the Divine will and invites sufferers to turn their misery to spiritual benefit and the scientific/technological view that asks how knowledge can be harnessed to the task of reducing the volume of suffering in the world.
For the religious zealots, gritting one’s teeth and coming to a spiritual accommodation with one’s pain gets one right with God for eternity, while popping an oxycodone and getting right quick but time limited relief from excruciating pain pampers the flesh but neglects the soul.
If these guidelines hold, there will be unintended consequence. Sales of ibuprofen will increase, as will overdoses of ibuprofen. More people will treat their pain with hard liquor. Suicides by pistol will increase as the opportunities for suicide by opium and ethanol decrease. Perhaps more holy books will be sold and thumped.
Will there be a net increase in happiness? I doubt it. Will there be a net increase in suffering that opioid painkillers could relieve? You can damn well bet the ranch on it.