Drug Seeking Behavior and other abusive stigmas

I get tired. Today one of my most adherent chronic pain patients told me today two things that pissed me off. 1) She was told by a podiatrist that she could not have surgical reconstruction of her ankle despite working hard to get her nicotine down because "You have fibromyalgia and your nerves will be worse after anesthesia."

I am going to give you a redneck translation to that statement, "I am not allowed to say fibromyalgia isn't a real diagnosis anymore, but you are still crazy". So potentially life enhancing surgery is being held from her because of stigma.

2) Then she told me that the ER has her listed as demonstrating "drug seeking behavior" - and the tears that just having these words in her chart made me wish I could leave the office, drive to that ED, and show my hind parts to any and all that hurt her like this.

It is long past time that we eliminate stigmatizing language for chronic pain patients. I get so tired of having to explain that physical dependence is a thing, addiction is a thing, and they are not the SAME thing. I serve both populations in my primary care clinic and everyone in both categories is some how able to understand the difference, and yet folks with supposedly a lot more education cannot seem to grasp it in it's simplicity.

However, let's assume for argument's sake that drug seeking is a thing. How does having a inappropriate relationship with opioids or other controlled medications make you ineligible for basic compassion - that is right - it doesn't.

So, today I did something for the first time that I am sure won't be the last time. I typed a warning to the folks I am referring her to for a second opinion. I told them she needed a COMPASSIONATE second opinion and that ANY WORDS in her chart about "drug seeking behavior is a abject lie." Followed with, "we stand ready to help manage our patient's pain if you find her eligible for reconstructive surgery".

How does the stigma end - one conversation at at time.

Don't be intimidated - if you don't know how to fight back yet, get a copy of my book. If you already have it, I currently need books donated for four people who can't afford it. Need a 1:1 coaching call, we got that too. Love you, No buts!