Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, October 31, 2011

Medical Pain Management

When it comes to pain management and doctors who prescribe adequate painkillers for their patients there isn't a whole lot to say in praise of doctors in general. Most doctors appear to feel that the opioids and other drugs to be prescribed for their patients suffering continual pain may make them responsible for the potential of patients becoming habituated to the pain-killers and hugely dependent on the drugs' addictive properties.

So the end result is that doctors tend to be overly cautious and people who suffer pain from all manner of sources simply continue suffering. Very few doctors are conscious of their responsibilities to their patients in this regard, and those few who are, tend to become specialists in pain management. They become dedicated to the struggle to aid people, and in so doing become their champions, while chiding their colleagues for not feeling compelled to pay greater attention.

And then there are those physicians who are overworked and exhausted and careless about the prescriptions they write for patients who take advantage of such opportunities, using prescribed medications for themselves, and the 'extras' that they are able to coerce out of the system for re-sale on the street where they're in high demand.

Doctors are held responsible for prescribing medications for their patients because they're the health professionals and as such cognizant of which drugs can be useful in particular circumstances. In prescribing those drugs they are assuring their patients that they know what is in their best interests. And should anything go awry they are held to be responsible but not really charged with that responsibility. (Personalities like Michael Jackson aside.)

So why it is that doctors have suddenly become nervous about Health Canada deciding to make doctors responsible for prescribing and monitoring the effects of medical marijuana, behaving as though they wouldn't want to touch it with a ten-foot pole? Isn't it the responsibility of any medical practitioner to monitor the progress of their patients for whom they've prescribed medication?

Why would medical marijuana be any different? Since it has been accepted as a proven aid in regulating pain in some people, and legally prescribed, it's hard to see why doctors are so nervous about its use and monitoring. After all, the bureaucrats at Health Canada cannot monitor patients; it is in actual fact the responsibility of individual physicians to do so in the best interests of their patients.

If doctors fear they may be exposing themselves to potential legal action because suddenly patients will view them as the fount of legal marijuana use, it seems common sense to prescribe it as and when required, not at random, not merely because a patient requests it, but because background medical checks make it a feasible option as a pain-control method.

Doctors authorize through writing prescriptions all manner of drugs and medications, not all of them without serious potential side effects. They weigh the risks against the obvious and proven gains to be had for each patient reflecting their particular needs and medical history.

What should be happening, as a reassurance and indeed a necessity, is that Health Canada continue funding research in the long-term effects of marijuana use. As with the use of any drug protocol, more could be known about the effectiveness, the mechanics of the interaction with the human body, and the potential long-time complications, should any exist.

There are those who argue that smoking anything is inimical to one's health, and there's truth to that. But if we're talking about living with unforgiving, unrelenting pain, and taking steps to ease that kind of pain, then we're also talking about trade-offs. And surely people have the right to make decisions for themselves and their quality of life in that respect.

To give the official line that this is the type of thing that pharmaceutical companies do and to leave it to them, is patently absurd when we're talking about marijuana, since there's no gain, no profit for drug companies in investigating its usefulness nor any possible side effects into the future.

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