Comments on Payne Hertz: Pain Contracts: "Cooperation," or Coercion?

I know this is an older blog but ran across it and...

2009-07-20T06:34:31.286-04:00

I know this is an older blog but ran across it and I have to say this is an awesome yet very disturbing description of what a "pain contract" is truly about. As a CP patient with chronic low back pain I went past my own comfort zone in how many Epidural Injections I had done all in the name of getting meds to control my pain. I spent over 5 years trying interventional treatments that did not work.

I just wanted to say thank you as this was an excellent piece.

Fantastic piece. I can't see how a doctor could fe...

2008-09-08T21:35:00.000-04:00

Fantastic piece. I can't see how a doctor could feel protected by a pain/opoid contract. If a patient refuses to sign, and tragically ends up killing themselves because of their chronic pain condition,

http://pn.psychiatryonline.org/cgi/content/full/41/23/25

could you imagine the lawsuit?

I'll sign their contract the day they sign one saying that all the apap/ibuprofen I take on a daily basis won't destroy my kidneys, GI tract or both.

Thanks again for the great post.

Thank You, thank you, thank you! You wrote exactl...

2008-04-21T22:37:00.000-04:00

Thank You, thank you, thank you! You wrote exactly what I think of the whole situation. I appreciate your words. Hugs and smiles

"The situation is so frustrating. Do you foresee t...

2007-11-15T19:23:00.000-05:00

"The situation is so frustrating. Do you foresee this changing in the future, and if so, how? Are there other countries that are less barbaric when it comes to prescribing pain medication (without resorting to the situation you describe here)? And where are they, if such places exist?"

That's a great question, M, and I don't have an answer. My impression from being on some of the support groups, and this is purely anecdotal evidence here, is that pain treatment is worse in the US as you rarely see the kind of horror stories Americans routinely post on these groups coming from people in other countries. When they talk about problems, it's usually due to having really complex conditions that baffle their doctors. For us, it's being humiliated, abused and denied treatment even when our conditions are clear-cut and readily treatable.

I firmly believe the only solution is to end prohibition. No other solution puts the power to control our lives back in our hands where it belongs. Anything less and I fear we will always have these kinds of problems.

Thanks for your thoughtful comment.

The situation is so frustrating. Do you foresee th...

2007-11-15T05:18:00.000-05:00

The situation is so frustrating. Do you foresee this changing in the future, and if so, how? Are there other countries that are less barbaric when it comes to prescribing pain medication (without resorting to the situation you describe here)? And where are they, if such places exist?

As you describe, the system here allows for almost or complete control over the patient decision making on the part of the doctor.

The options are do as the doctor says and abdicate your right to decline unwanted treatments and medications, or make your own informed choices and leave your intolerable pain untreated--the latter "option" not being a real option at all.

The assumption of guilty before proven innocent--the belief that the patient is in need of a contract to dictate his or her behavior--is offensive; the lack of patient autonomy and choice as demonstrated in the use of these so called contracts, just plain dangerous and frightening.

Nicely done!If only this were required reading for...

2007-09-04T17:06:00.000-04:00

Nicely done!

If only this were required reading for all doctors who use such contracts.