Dear Surgeon General Vivek Murthy

http://www.huffingtonpost.com/entry/vivek-murthy-report-on-drugs-and-alcohol_us_582dce19e4b099512f812e9c

“Addiction is a chronic disease of the brain and it’s one that we have to treat the way we would any other chronic illness: with skill, with compassion and with urgency,” he added.

If addiction is a chronic disease of the brain, how does the surgeon general describe chronic and intractable pain? Is intractable pain also a chronic disease of the brain? I’m curious, does the surgeon general believe that addiction and chronic pain are the same medical condition?

“Many people didn’t want to talk to the surgeon general if the press was around, because they were afraid of losing their jobs and friends if anyone found out about their substance use disorder, Murthy explained. They also worried that doctors might treat them differently. The numbers bear out that fear of stigma.”

Those who suffer from chronic pain are now learning what it feels like to be treated like a drug addict — afraid of losing jobs and friends, facing abandonment and stigma by the medical industry, being told their pain doesn’t matter, and being denied insurance coverage for many prescription medications. Since the surgeon general is partially responsible for the stigma faced by pain patients every day, what is he going to do about it?

Why does the surgeon general think that treating addiction is more important than treating chronic pain, especially since millions more people suffer from chronic pain than from addiction?

“The overarching theme of the new report is that substance use disorders are medical problems, and the logical next step is integrating substance use disorder care into mainstream health care.”

Isn’t it just as important to integrate the adequate treatment of pain into mainstream health care? You know, pain — the main reason people go to the doctor? Why are expensive specialists needed to treat addiction and chronic pain, especially since the government has pretty much mandated specific standards for the treatment of both medical conditions?

“What’s really at stake here are our family and friends,” he said. “Addiction is not a disease that discriminates and it has now risen to a level that it is impacting nearly everyone.”

Everything the surgeon general has said about addiction holds true for chronic pain, too. But there’s more than one difference between the two conditions.

For the treatment of addiction, it is necessary to find and treat any underlying trauma or mental conditions that may have triggered the addiction. The mental conditions may be chronic, but the addiction doesn’t have to be. But without treating the main condition — like depression, PTSD, or bipolar — trying to treat the addiction is just a waste of time. Why doesn’t the surgeon general mention this very important part of treatment?

Intractable pain is always a chronic condition. The underlying condition has already been treated (again and again) and is sometimes caused by the very medical treatment that was supposed to help. Does the surgeon general believe there is some benefit to untreated pain and constant suffering?

“A few specific recommendations include adding addiction screenings in primary health care settings and hospitals…”

If you’re a doctor, go ahead, ask me if I’m addicted to drugs. I dare you. Just another reason to avoid the doctor, so all your personal medical information doesn’t end up in some government database. And do I have the right to ask the doctor the same question? Isn’t the addiction rate higher in the medical profession than in the general public?

The surgeon general is trying to help those who suffer from addiction, but how is he going to help pain patients? Just with the letter asking doctors to disregard and belittle their patients’ reports of pain?

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