It's nice to have a thread to vent.
As far as the opiods go there seems to be a mass amnesia among the "experts" re the pain initiative era 10-15 years ago. We were openly instructed to give patients the benefit of the doubt and prescribe narcotics. I was working ED's at the time and we were instructed to get the patient's pain score down by half, ie if they came in at an 8 they should be a 4 or less on discharge. The only way to do that was narcotics and the approach was of course heavily abused by some patients.
Most pain specialists around here just want to do injections, put people on gabapentin and send them to therapy. There will be many patients where that will not work and they are told to just live with the pain. And I agree there is nothing magical about cancer pain that somehow differentiates it from other pain. The current approach is a mess and good patients will suffer.
