While federal investigators try to track down Kentuckians who go out of state to secure prescription pain pills to sell or abuse, many Kentucky doctors are wrestling with questions of how and when to treat thousands of legitimate patients who need those same drugs.
It's all part of perhaps the hottest national debate in medicine today.
The discussion revolves around two camps. One holds that pain essentially is an illness in its own right that should be treated aggressively, up to and including the use of powerful narcotic drugs. The other side contends that doctors must be much more conservative, offering narcotics only when they're absolutely sure patients actually need the potentially addicting drugs and are not seeking them to abuse them.
Some nationally known experts, like Dr. Russell Portenoy, a New York pain specialist, say the debate has left many doctors reluctant to prescribe narcotics because they fear being investigated by authorities and many patients reluctant to seek help because they fear being seen as ”pill users.“
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