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Coroner letters changed habits of doctors whose patients died of overdoses

latimes.com

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Re: Coroner letters changed habits of doctors whose patients died of overdoses

#11

Post by rz2k »

duncan-donuts wrote: post #3

Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.

Search: “Pain is the fifth vital sign”

There was a very strong campaign to re-educate physicians to not consider pain as only a symptom. It was suggested that there was liability in not treating pain for the sake of getting rid of pain alone, but mostly it didn’t just change prescribing practices out of fear of liability, the focus of attention on pain changed prescribing habits.

In practice, someone who hardly has enough time for the patients they see, may subconsciously think that in spite of the prevalence of national opioid deaths, no one they treat has died or destroyed their lives through addiction, simply because those who do also stop booking appointments.

These letters sound like a great idea.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#12

Post by thomasfedb »

cheeze wrote: post #6
duncan-donuts wrote: post #3

Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.

Everybody is aware. Many just don't care.

I think this is mean and unnecessarily so. People have pain and expect doctors to fix it, but the tools we have to treat it are dangerous. Going too far either way will cripple or destroy lives. Getting the balance right isn't a job anybody is envious of.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#14

Post by xup »

duncan-donuts wrote: post #3

Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.

Another factor: Many doctors and hospitals are rated according to patient satisfaction, with reimbursement rates from the government partially based on those satisfaction surveys. And in many cases, if patients have any pain whatsoever, they rate the doctors and hospitals poorly, and therefore the doctors and hospitals get a lower reimbursement rate from the federal government. So doctors and hospitals are incentivized to make patients have no pain whatsoever in recovery, in order to have higher reimbursement rates, even if it means addiction in the long run.

Source: Many doctors in my family who talk about their experiences.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#16

Post by nostromo »

slededit wrote: post #7
duncan-donuts wrote: post #3

Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.

The article states most doctors think they prescribe below average amounts - similar to everyone thinking they are an above average driver.

It’s entirely possible, even likely, that most doctors prescribe below average amounts.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#17

Post by Agentlien »

evfanknitram wrote: post #10
icu wrote: post #4

LA Times seems to be blocked for the UK, presumably due to GDPR.

I assume blocked in all of EU.

Seems likely. It's blocked in Sweden and the message says it is currently "unavailable in most European countries".

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#18

Post by cm2012 »

One note: Research pretty thoroughly debunks the idea that a substantial percent of opioid as addictions come from prescribed pain treatments: https://www.fivethirtyeight.com/features/what-science-says-t...

Now this article is about something different - teaching doctors the warning signs of when already addicted patients are drug seeking, so they can avoid prescribing then. The key fact here is that almost all of the deceased had gotten prescriptions from multiple doctors.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#19

Post by baxtr »

duncan-donuts wrote: post #3

Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.

I guess it’s also an cultural issue. If it’s ok to mute any pain, then not giving opioids is maybe not even considered.

My father had 2 bad operations last year. He suffered a lot of pain afterwards, but he refrained from taking strong drugs. I’m not sure if he did the right thing and if I’d do the same. But there’s is definitely middle ground between killing every pain and enduring all of it.

I found this article interesting: https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-ge...

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#20

Post by cm2012 »

duncan-donuts wrote: post #3

Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.

Just FYI, doctors very rarely cause opioid addictions: https://www.fivethirtyeight.com/features/what-science-says-t...

As the article shows, at worst they get bamboozled by addicts sometimes, who go to multiple doctors and lie.

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