[DigitalJack]

Well, I sort of agree. I work with several fibromyalgia groups, and it's a simple fact that pain management in america is abysmal. The regulation of prescription opiates so onerus, it makes it extremely difficult for patients to get, and doctors to prescribe, the medication that would have a massive difference in their quality of life.

It is because of this that they find alternatives/substitutes, which range from alcohol to heroin to suicide. Two people I know have killed themselves because they could not deal with the pain and the medical system failed them.

[wycx]

I find the attitude of doctors to chronic pain for which they cannot provide a solution to be very frustrating.

Why is it that opiate addiction is seen as far far worse than debilitating chronic pain? Why can't the patient make that choice?

[DanBC]

For most people with long term pain an opiate prescription is the wrong choice.

The patient ends up with an addiction of opiates; while taking dangerously large quantities of opiates; while still being in pain.

They've still got the pain; they now have two additional problems.

Most people with long term pain need access to pain management services which include other stuff (exercise, physiotherapy, weight loss, psychological therapies) as well as (if needed) opiates.

[DigitalJack]

None of those are alternatives that make sense with fibromyalgia. I could see them for lower back pain.

The thing with fibro is that pain causes reactions that make fibro worse, such as sleep deprivation.

Opiates can break this cycle through a short term course.

[wycx]

Except that the primary focus of pain management services seems to be overwhelmingly about reducing opiate intake, rather than helping the patient deal with pain.

Maybe there are no good choices for some long term pain.

[DanBC]

I don't know where you are, but in England most pain control clinics are mostly about helping the patient deal with pain, and using appropriate medication to do so.

Here's the English guidance for managing pain in non-specialist settings, so this is what people should be getting from a regular doctor. (For neuropathic pain).

http://www.nice.org.uk/guidance/cg173/chapter/1-recommendati...