There are aches and pain of daily life and then there is
pain: post-operative, orthopedic or associated with cancer. In the acute
situation pain relief will lead to less stress on the body and the mind with
the hopes of accelerating recovery. This type of acute pain is an appropriate
use of narcotics. In the unfortunate situation the pain becomes chronic. In the
past one learned to live with the pain but then the tide turned and the goal
was to make everyone ‘pain free.’ The unintended consequence of a ‘pain free’
existence has been an epidemic of drug abuse.
The use of narcotics may be entirely appropriate in acute
and self-limited situations but the long-term goal now is to maintain
functionality even the face of pain. Complementary medicine, such as acupuncture,
plays an important role in the management of pain. Health care practitioners
are embracing a new paradigm, some more enthusiastically than others.
The Department of Consumer Protection in Connecticut
monitors all dispensing of controlled substances. These include sleeping pills,
tranquilizers, codeine cough medicine and most pain medications. From the
website: The prescription
monitoring program collects prescription data for Schedule II through Schedule
V drugs into a central database, the Connecticut Prescription Monitoring
and Reporting System (CPMRS), which can then be used by providers and
pharmacists in the active treatment of their patients. The purpose of
the CPMRS is to present a complete picture of a patient’s controlled
substance use, including prescriptions by other providers, so that the provider
can properly manage the patient’s treatment, including the referral of a
patient to services offering treatment for drug abuse or addiction when
appropriate.
Prescriptions
for controlled substances cannot be called into a pharmacy but must be written
on special paper. The prescriber is mandated to check the database for any
prescription for a more than seventy-two hour supply of medication.
Prescriptions for chronic pain are typically written for a twenty-eight day
supply with the ultimate goal of weaning the patient from narcotics to other
modes of pain management.
