150 karma · joined October 26, 2013
People who are regularly in great pain would read this comment as saying "you are being mauled by a bear, but if you have ripped your own vocal cords out so that you're not constantly screaming, we judge that preventing the bear from mauling you won't affect the environment much (since the screaming level will not change), so we will not prevent the bear from mauling you".
I know what you are trying to say, but phrasing it like this is harmful. Psychosomatic issues are absolutely legitimate. Knowing it's psychosomatic means there may be other avenues of addressing it than if it wasn't, but calling the issues "not legitimate" is very problematic, akin to telling someone with depression "just think happy thoughts".
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In practice, living the years I have with my wife, the answer seems to usually be "assume that you, as a doctor, have much more knowledge about your patient's experience and that because no test you know how to do dings 'yep, a problem', that the patient in fact _does not_ have a problem, that their claims of being in enough pain to want to die at least a few times a week are made-up, that they've lived this long with their 'must be just in their head' problem that surely it's not so bad and they can keep doing so".
From a purely probabilistic standpoint, they might be right.
From my wife's perspective, they are torturing her, hopefully not to death.
What _do_ you do?
The study did not find that. The study looked for long-term opioid use, not addiction, and not dependence. Long term use, addiction, and dependence (and tolerance) are all separate things.
Long-term use: simply using a thing consistently for a long time Addiction: compulsive seeking, not noted in any of your links Dependence: something bad happens when use is discontinued Tolerance: more use is required to get the same effects