And that, my friends, is how we have gotten into the pickle of potentially overmedicating, overnarcotizing, and oversedating patients sometimes to dangerous levels. That doesn't just lead to sleepy patients......it can lead to death.
He then goes on to cite this paper from the Journal of the American College of Surgeons. The investigators set out to test the premise that present day use of unscientific pain scales causes injury and death from overmedication by comparing adverse events in time periods before and after the promulgation of pain rating scales and other pain management dogmas (1994-1998 and 2000-2004, respectively). The study showed an increase in the rate of deaths due to overmedication in the 2000-2004 period and concluded:
The current assessment of pain by computer-stored pain scales is in a state of imbalance, with excessive emphasis on undermedication at the same time ignoring overmedication. This imbalance reflects pain-service attempts to comply with external accrediting agencies. This preventable cause of death and disability in trauma patients is also occurring in noninjured patients. Surgeons must correct this problem by insisting on a balanced assessment of overmedication versus undermedication.
These unintended consequences were not unanticipated. But as the pain management initiatives were rolled out 8 years ago practicing doctors’ safety concerns were largely ignored.