For Prince

Yes, that Prince. A bit of a confession - I’m not much of a fan of the music, and I haven’t listed to any albums since I got Purple Rain on cassette for my Bar Mitzvah, but I give him props for creativity and ingenuity. I was, however, particularly struck that the apparent cause of death - overdose of pain killers - while tragic, can serve as a lesson for us all on a number of levels, and how the use, overuse, and abuse of pain killers impacts us as doctors and patients.

Since the 1500’s, various forms of narcotics - that is drugs in the heroin and morphine family - have been used to treat various forms of pain, and the use skyrocketed in the 20th century. And as use increased so has abuse, to the point of 80 deaths per day from prescription painkiller overdose in 2014. Unfortunately we’ve seen the Prince movie before - talented and wealthy celebrity with access to powerful drugs through celebrity doctors, with an equally tragic ending and a lot of hand wringing and head scratching on the part of the public, medical community and government. And there is no question we need to address the abuse and prevent further tragedies by controlling access and monitoring all patients better, just as celebrity patients need to be treated more like patients and less like celebrities, IMHO. However, let’s not completely lose sight of the benefits of analgesia, the quality of life improvement for those who live in acute and chronic pain and can now live a pain free life.

In our NYC practice, pain is controlled. It’s quite expected that foot surgery, or any other type of surgery, is painful for at least a few days or more. With properly controlled and monitored painkillers, patients need not suffer. Yes, it’s ok to take strong narcotic based analgesics after surgery or a trauma such as a fracture or a bad sprain. But as the foot or ankle heals, the analgesics are appropriately decreased and transitioned to non-narcotic based pain relievers. For those with chronic pain issues, we try to address the root cause of pain, and if that’s not possible, the long-term medication management is handled by competent and compassionate pain management specialists who can ascertain the best method of controlling pain and maintaining quality of life while preventing abuse.

Every tragedy is tragic, to state the obvious. We need to monitor and control pain killer use while ensuring access to those who are in need. It is possible, and it does happen every once in a while, for the people, medical community and government to come to a consensus and accomplish something meaningful. And that’s progress.

See you in the office.

Ernest Isaacson

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