CULTURAL ASPECTS OF PAIN: PATIENTS ARE NOT THE ONLY PLAYERS

Can doctors also play the ‘pain game’? Doctors are at least partly to blame for the public’s rampant use of drugs. Some find it all too easy to reach out for the prescription pad, encouraged by extravagant drug company advertising and ‘free’ samples and by too little time for too many patients, or by too many apparently impossibly difficult problems. Drugs to wake you in the morning. Drugs so you can keep driving when you’re exhausted. Drugs to help you sleep.Drugs to prevent pregnancy. More drugs to cure headaches or a dozen other ‘quick-fixes’. In plain terms, drugs are the easy way out for a doctor faced with a patient who keeps insisting: ‘Doctor, do something!’

The ‘easy’ way out

It may be rare in this era of ‘ Three minute medicine’ to find a doctor who is prepared to take the time to earnestly try to come to grips with a patient’s problems. Patients may also wish to avoid the issue. Or,they may simply not be able to identify the real cause of their chronic pain.

Doctors are bombarded with advertising and scientific journals extolling new drugs and treatments. Patients read about a new miracle treatment and build up the expectation that this is the answer to their problem. On the other hand, rare is the patient who hasn’t been victimised by the ‘It’s all in your head!’ game. The doctor can all too easily dismiss the problem he or she cannot or does not want to solve by simply prescribing tranquillisers. Valium is now the world’s biggest selling drug — despite it being widely recognised as causing emotional depression and even physical dependence when used for overly long periods.

Patients who ‘doctor shop’, picking up several prescriptions along the way, often take a combination of tranquillisers and pain relievers — with devastating results. Even the minor tranquillisers have well-known side-effects and problems associated with withdrawal. When used properly, as muscle relaxants or anxiety-relieving drugs, they still have a major place in medicine in general and the treatment of the patient with chronic pain in particular.

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