When winter weather leads to treacherous conditions, asthma and diabetes patients can at least rest assured that their albuterol inhalers and insulin can still be prescribed without the patients having to leave the comfort of their homes. People living with chronic pain, though, are not as fortunate. Even hydrocodone (the most commonly prescribed medication for pain) is a Schedule II medication, which means it cannot be called in to a pharmacy and requires a hard-copy prescription. That poses a significant burden on patients, their families, and providers.
Even if snow or ice do not prevent patients from getting to their respective pain-management providers, it may very well prevent the providers from coming in (as was the case at PCET on a few different days in February). Clearly, it is important for us as clinical experts in pain management to treat patients as definitively as possible. This helps minimize the need for the patients to routinely take controlled substances for pain. In doing so, patients are spared the added psychological and physiological burdens which come from running out of medication in the middle of a widespread weather event. While running out of those medications is not typically life-threatening, there are some people (such as those with a history of stroke, heart disease, and hypertension) for whom opioid withdrawals may pose very real risks. So, when patients wonder why we refrain from going straight to the prescription pad at their first mention of a pain complaint, it is because we genuinely have their long-term best interests at heart, not just their interests for the next day or week.