As someone who experiences pain on a daily basis, I am interested in exploring and discussing the issues surrounding the fact that many so-called ‘pain management’ clinics refuse to prescribe opiate based pharmaceuticals, aka narcotics, to chronic pain sufferers. I have had cauda equina syndrome for approximately two years, and still experience considerable pain, even though I DO receive narcotic treatment in the form of methadone. Here’s the catch: I have to travel almost 2 hours to an out-of-state pain management center because there are no local clinics in my medical insurance formulary that treat pain with narcotics. Let me put that another way. All the pain management centers in my medical insurance formulary DO NOT prescribe narcotics for pain, regardless of the severity or duration of that pain. It’s not that I have poor medical coverage, it’s that these pain management centers are under the misguided impression that they can adequately treat severe pain without any opiates, the most familiar being codeine, percocet, vicodin, morphine, oxycontin, etc. At first, I thought there must have been some misunderstanding. When I was told that all the pain management centers in my area did not prescribe narcotics, I thought to myself, “Well, surely they just mean that they don’t prescribe them right away. I understand, I have to be evaluated first. There must be some process one has to go through before they start handing out prescriptions.” I was wrong. There is no process. There is no evaluation. There is no criteria that a person must meet, because there is no criteria! There are no circumstances in which they consider it necessary to use opiates to relieve pain. Call me naive, but I thought the same thing you are probably thinking now, as you read this: well that doesn’t make any sense; it’s not like there are no doctors in CT who prescribe narcotics! And you would be right, to a point. You may get a few vicodin or percocet from your dentist after a procedure, and you may well be sent home from the hospital with a fair and adequate amount of narcotics. You may even receive a narcotics prescription from your family physician. What you may not know, and the reason I write this article, is that if you are in the unfortunate group of people who are forced to live out their lives in constant pain… you will be told statistically inaccurate stories about how there is no safe or effective way to relieve pain with narcotics for an extended period of time, and that you must consider other options. Don’t get me wrong, I’m all for considering other options. In fact, I believe all the other options should be considered before using narcotics, however, there are some instances where the pain is too severe and the use of opiates is the best option. I am familiar with nerve stimulators, if that’s the option that came to mind. The problem is, where I am you have to wait two years before the use of a nerve stimulator will even be considered. I welcome comments, questions and information. Although my pain is being treated as aggressively as can reasonably be expected, I can not help but wonder about all those who must certainly be suffering because of this bygone and spurious notion that opiates do more harm than good. I can, and possibly will write a detailed and honest description of what prolonged pain can do to a person. I’ll leave you with this thought; it does more than just hurt. Below is the address of a REASON MAGAZINE article on “opiophobia”, a term used to describe physicians’ fear of opiates. There are hundreds of others, but I’d like to hear from you… http://reason.com/archives/1997/01/01/no-relief-in-sight