I spoke with another migraine patient today who told me that despite (and likely resulting from) weekly visits to the emergency room because of severe migraine pain, the doctors there have labeled her as drug seeking and refuse to give her pain medication.
This is a very, very unfortunate but very very common report from migraine headache patients that I speak with. It’s hard to understand the other side of the argument when you stand on either side of the chronic pain medication fence, but there are understandable points on each side.
From a migraine headache patient’s perspective, it seems as though the doctors and nurses are withholding helpful medications and sometimes this verges on what appears to be malice. Speaking for myself who suffers from migraine pain, when you will do just about anything to find relief, the concept that someone can help but refuses to makes little sense and I’m certain this would become infuriating.
From a doctor’s perspective, the worsening narcotic epidemic is one of the principal public health issues facing the United States today. Providing those people who actually are drug seeking (and there are MANY of those people) with further narcotics goes against the first rule of medicine… “Do no harm.” Feeding the narcotic addict’s addiction with more prescription medications is making things worse for everyone, including the addict who needs help, but not more medications.
The vast majority of migraine headache sufferers are NOT narcotic seekers nor addicts nor asking for narcotics to feed a habit. The problem is that for a physician, there is nothing measurable or observable to indicate that someone with a headache is actually in severe pain. There is no open wound, no blood, no x-ray showing a broken bone. The otherwise normal appearing man or woman complaining of severe pain in their head could be real, or could be faking and just looking for a prescription.
I’m not sure how to solve this problem, though mutual understanding between the patient and the doctor might help. A pain medicine specialist can often aid with prescription management, but seeing these doctors over and over can become a financial burden. My obvious answer is to fix the migraine headache with nerve decompression surgery, but not everyone has the ability to travel or see me or one of my colleagues.
I’m very sympathetic to migraine headache patients who have been subjected to this situation. I see them as another victim of the problematic narcotic epidemic in the USA. While migraine patients are not actually part of the problem, they are subjected to the circumstances that surround other drug seeking patients.
The woman I spoke with today began our conversation in a low monotone, and I’m sure she was expecting me to think her crazy as she has heard this from so many doctors before. I think she was surprised as I continued to listen, then discuss her situation, and explain how migraine surgery can likely help her. By the end of the conversation, you could hear how she had perked up, and how the prospect of coming to see a doctor who understands turned her entire attitude around. She is looking forward to coming to see me next month and though she is making the trip from about 700 miles away, we are both excited about the possibility of putting migraines and trips to the emergency room behind her.
