Pain and suicide: the other side of the opioid story.

A former patient whom I’ll call Jack came to me for help after three back operations. He was on disability because of his pain. I treated him for about four years, struggling all the while to get his insurance to cover his therapies. I tried to get him to see a psychologist, but his insurance would not pay for the service. He was on what most physicians today would term a high dose of opioids and other medications. I wasn’t convinced that the higher dose was any more effective than a lower dose. He was mostly inactive and reported little improvement in pain or function while on his medication.