I recently got yelled at for not prescribing opioids (again)

Recently, when I was working a shift in ER, a patient became confrontational and unleashed a flurry of expletives at me and my nursing colleague because I had explained that I would not be prescribing opioids for pain. The patient's chronic pain was being managed with a pain management doctor and primary care doctor. But the pain wasn't being controlled.

This isn't an uncommon scenario. In the ER, we see it all the time. Even though the encounter I just described was a challenging one, it could've been much worse.

Everyday, 78 people die from opioid-related overdoses in the U.S.

Opioids have a role in treating pain, but they should not be the mainstay of treating pain.

So what are all the options? The joint commission and many other organizations have advocated for the use of integrative, non-pharmacologic methods for treating pain, including meditation. We need these resources available at our fingertips in the ER and throughout healthcare.

How might meditation treat pain and help curb the opioid epidemic?

Broadly, meditation increases our buffer, so that pain and stress don't get to us as easily. It can help break the cycle of addiction. Remember that it's not pain itself that really bothers us, it's the suffering we experience when our brain interprets pain.

Pain signals from the body reach the brain and are then interpreted into an actual experience of pain, often suffering. This is no different than how the brain receives signals from the eyes and then interprets what we see.

Meditation works by influencing how we interpret pain, and in doing so it can lessen suffering.

Can that be done in an ER? I believe it can, if enough healthcare personnel are experienced. But we don't have to wait for a formal program to bring this experience of wellbeing into stressful situations. We can start now.


Anoop Kumar, MD, MM is an emergency physician in the Washington DC metro area. He helps people translate wellbeing into daily life. He is the creator of Meditation Starter Kit and the author of Michelangelo's Medicine: How redefining the human body will transform health and healthcare.