One of the most difficult challenges any primary care physician faces is the treatment of chronic pain. Each patient and situation is unique. I’ve seen terminal cancer patients trying to live out their last days comfortably, people struggling all their lives with debilitating autoimmune diseases, laborers whose bodies have worn out from years of back-breaking work, and those with depression and other mental health problems that make their experience of pain more intense.
Twenty years ago, as a medical student and resident physician, I learned about new and promising techniques to treat chronic pain. The innovations ranged from biofeedback to acupuncture to cognitive behavioral therapy to trigger point injections — therapies as varied as the types of pain they were intended to treat. Emphasis was placed on tailoring the treatment to the individual patient. Narcotic pain medication was reserved only for cancer-related or terminal pain because of the high risk of addiction. Then, in 1996, a wonder drug was touted as the answer for all kinds of pain with almost no risk of addiction according to the manufacturer, Purdue Pharma. The magic bullet was called OxyContin.