Opioids and pain in the emergency department: a narrative crisis

Med Humanit. 2018 Sep;44(3):213-216. doi: 10.1136/medhum-2017-011429. Epub 2018 Jun 26.

Abstract

The opioid crisis poses challenges to patients who come to the emergency department (ED) in pain and the clinicians who have a duty to offer relief. In search of help, patients often find suspicion. But clinicians have reasons to be concerned about feeding addiction and its lethal consequences. This article discusses the narrative challenges facing many clinicians in the ED tasked with caring for complex patients in pain. It will discuss the many ways our brains are influenced by story, and how this susceptibility is often beyond our grasp. And yet, narrative and story skills present great opportunities for improving pain management, not only when it comes to opioids, but by returning the focus back to the patient in pain.

Keywords: emergency medicine; medical humanities; narrative medicine; opioids; pain management.

MeSH terms

  • Adaptation, Psychological
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Attitude of Health Personnel
  • Brain
  • Caregivers / ethics
  • Caregivers / psychology
  • Comprehension*
  • Decision Making
  • Emergency Service, Hospital*
  • Guideline Adherence
  • Humans
  • Moral Obligations
  • Narration*
  • Pain Management / ethics
  • Pain* / drug therapy
  • Pain* / psychology
  • Physicians / ethics
  • Physicians / psychology*
  • Social Problems
  • Substance-Related Disorders* / psychology

Substances

  • Analgesics, Opioid