Opioids and pain in the emergency department: a narrative crisis

The commentary by Jay Baruch and Stacey Springs, ‘Opioids and pain in the emergency department: a narrative crisis’, is available through open access in the current issue of Medical Humanities.

A young woman presents to the emergency department in a sickle cell crisis, complaining of unbearable pain. When asked to rate it on a scale of 1 – 10, she rates it at 10. Having received a does of opioids and other medication, she is talking and laughing, and seems to be in less discomfort. However, when asked to rate her pain again, she maintains that it remains at 10. Is this opioid seeking behaviour?

Baruch and Springs suggests that the subjective nature of pain and the backdrop of the opioid crisis in the USA, present ‘major obstacles to understanding, appreciating and responding to patients complaining of pain’. They work through the ‘narrative challenge’ that pain presents, and the prospect of addressing this challenge by means of greater proficiency with stories.

Baruch explains it better in the brief audio-clip below.

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