We are never giving drugs in the ER

I was suffering for lack of inspiration tonight, but then I thought, surely there must be something to get angry about. I wrote a rant about rounding pennies, I can write a rant about anything. Anything can be outrageous if you overthink it enough.

Take this cute video…

http://www.ems1.com/drugs/video/2089706-Taylor-Swift-parody-highlights-ER-drug-abuse-/

A very well done parody of a Taylor Swift song that I’m not familiar with. It’s about prescription drug abuse. Starts off with a shocking statistic (opioid prescriptions increased by 2.77 times from 1991 to 2010) and a shocking graph (opioid overdose deaths approximately tripled from 1999 to 2010). OK, it would be nice if those dates matched, but that’s being unnecessarily pedantic.

Unnecessarily pedantic is a different set of rants.

This video is from the United States, the statistics are most likely from there. That becomes important when you dig a little deeper.

The song is about refusing to prescribe opioids in the ER. A laudable goal, you might think. What better way to reduce overdoses than to keep such drugs the domain of PCPs, so that a patient’s history is known when they try to refill!

Well as it turns out in the United States the ER is the only form of health care for a shockingly high number of people. You see, they are required by law to provide medical care to anyone who reaches their doors, even if that person can’t afford to pay.

About 50 million Americans lacked health insurance in 2012. That number is down now, perhaps by as much as a third, though I couldn’t find any hard numbers. Still, over ten percent of the population doesn’t have access to the sort of physician that this song would recommend be the sole source of painkillers.

Pain is a medical problem with devastating effects, and chronic pain - the pain that might require an opioid prescription to take home - can be a profound disability. Pain is under-treated in every medical system. In part because it’s hard to measure, in part because the effective treatments are dangerous. Those parts of the problem are beyond current technology to deal with. But this isn’t… this is a political issue. I would hate this to be another way for lives to be worsened by a callous disregard for anyone unable to get a regular doctor.