Bureaucrats are telling your doctor how to treat pain. And patients suffer needlessly
Thanks to pressure from lawmakers, government agencies and policymakers who inserted themselves into the patient-doctor relationship, patients became the victims of the never-ending war on drugs.
A decade ago, most people thought of Tylenol (acetaminophen) as a medicine for fever, malaise and minor aches and pains. Nobody imagined that it would become the go-to drug for treating moderate, let alone severe, postoperative pain.
But this is just what has happened. Thanks to pressure from lawmakers, government agencies and policymakers who inserted themselves into the patient-doctor relationship, patients became the victims of the never-ending war on drugs.
Now, doctors frequently offer only acetaminophen to treat painful conditions despite the drug’s inability to remedy them.
Doctors pressured to avoid pain medication
Policymakers’ exaggerated fear of opioids has pressured hospitals, doctors and dentists to switch to acetaminophen, no matter how severe the patient’s pain. Sometimes, the drug is given intravenously in high doses as part of “opioid-sparing protocols.” We believe using the drug in this way is ill-advised, cruel and borders on malpractice.
Lawmakers believed they had to do something about the opioid overdose crisis, which has grown exponentially since the 1970s. The crisis was driven by a growing population of nonmedical drug users accessing drugs from the black market.
States dictate rules on prescriptions
Now, nearly 40 states have passed laws dictating the maximum number and dose of opioids that doctors are permitted to prescribe to their patients, all based on the misguided notion that medical use of prescription pain pills caused the crisis.
But what’s really fueling overdose deaths is drug prohibition and the dangerous black market that it creates. The Centers for Disease Control and Prevention got into the act by guiding doctors in treating pain, an area not in the agency’s wheelhouse.
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The evidence clearly shows that acetaminophen alone is a poor choice for treating most types of pain. Multiple literature reviews show that the drug has limited analgesic utility. Several Cochrane systematic reviews, which are highly regarded, evidence-based analyses that carefully evaluate the quality of data in numerous studies, have questioned its ability to relieve pain caused by a variety of conditions. With few exceptions, it fails miserably.
For example, studies reveal that acetaminophen effectively reduces fever in children. But, while the drug is frequently recommended for headache pain, its efficacy is mostly imaginary. A 2016 Cochrane review examined 23 studies, including more than 8,000 people with tension headaches. While 59% of the participants experienced relief within two hours, so did 49% of the group that received a placebo.
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A 2013 Cochrane review found the drug inferior to ibuprofen for reducing dental pain at all doses studied.
Perhaps most telling is a 2021 review that included 36 systematic studies of 44 painful conditions. It concluded that acetaminophen provided modest pain relief for one of them, osteoarthritis of the hip and knee. There was no sound evidence of the drug’s ability to treat any other painful condition.
Yet now, some doctors give it intravenously for postsurgical pain, a cruel and unethical practice if there ever was one.
Patients suffer agonizing pain
The government promulgates an erroneous fear of opioids that makes patients often endure agonizing postoperative pain they never would have experienced a decade ago, a violation of basic medical standards.
Yet, contrary to politicians’ beliefs, data show that the addiction rate of medically used opioids has been about 1%. Government data also show no correlation between the volume of opioids prescribed and the rate of abuse or addiction.
The treatment and management of acute and chronic pain involve the same nuanced medical decision-making as treating hypertension, diabetes, infectious diseases and psychiatric disorders. Just as it is wrong for the government to dictate how doctors treat those conditions, it should butt out when doctors treat pain.
Doctors take an oath to ease suffering and do no harm. Government meddling is causing doctors to violate their professional credo.
Dr. Jeffrey A. Singer practices general surgery in Phoenix and is a senior fellow at the Cato Institute. Josh Bloom is director of chemical and pharmaceutical science at the American Council on Science and Health.
Filed under: General Problems
[…] There was no sound evidence of Acetaminophen’s ability to treat most all painful condition […]
Thank you for revealing the medical truth about opioids.
U know,,never did i think ,”torture in the healthcare setting,” via denial of EFFECTIVE physical pain relief would be legal in America for all with painful medical conditions that stop them from functioning,or even functions they have no control of,like breathing,,,but it has,,torture has been made legal by the like of kolodny/addiction psychiatry and others who think they have the right to decide,how much forced physical pain another humanbeing should forcible suffer,,Again,,torturing the weakest in our society,use to be crossing the red line,,,,not anymore in America,,and those who were suppose to STOP IT from ever happpening,,,,never did,,,because MONEY is more important then the well-being of the medically ill in physical pain from there medical conditioins.1st and foremost relief of the physical pain should of always remained 1st,,,sorta out why,,with proper medical testing,,but noo,,,$$$$,, FORCED psych evals,talking about your pancreatitis will fix it,,really??Never forcible combine the medically ill in physical pain and psychiatry,ever,u have made torture legal by doing so.,,Bring it back to 2 seperate entitis,,Again,,your choice,but they even took that choice away now a days,,why,,for $$$$$$,,,THEY KNEW OUR MEDICINE WORKED,,THEY KNEW IT,,AND DID THIS ANYWAYS,,AND WERE SUPPOSE SUFFER AND BE HAPPY ABOUT IT,,,SORRY,,,NOT THIS PAIN PATIENT,,EVER,,FOR TORTUREING THE WEAKEST,THOSE WHO CAN’T DEFEND THEMSELVES,,NO,,,THATS NOT A HUMANE SOCIETY EVER,,,jmomaryw
“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
amen,,,u nailed as always,,,,,maryw
Thank you to all doctors like Doctor Jeffery Singer and Josh Bloom director of chemical and pharmaceutical science for following the facts and not listening to the Nin com poops that are causing the misleading findings that are killing over 15 thousand NASID using patients a year!