Debra Rae Drew

Abstract Prescribing and administering opioid doses based solely on pain intensity is inappropriate and potentially unsafe for many reasons, including that pain intensity ratings are completely subjective, cannot be measured objectively, are dynamic as the experience of pain is dynamic, and may be describing a construct other than intensity (i.e. suffering). Many factors, in addition to pain intensity, influence opioid requirements and subsequent dosing.

Abstract The foundation of safe and effective pain management is an individualized, comprehensive pain assessment that includes, but is not limited to, the intensity of pain if the patient is able to report it. An unforeseen consequence of the widespread use of pain intensity rating scales is the practice of prescribing specific doses of opioid analgesics based solely on specific pain intensity ratings. Many factors in addition to pain intensity influence opioid requirements.

I have not always agreed with Cory Farley, but he was unfairly attacked in a recent letter to the editor (“Columnist Farley miscasts the opioid crisis as a political issue,” Dec. 20). I am sick of hearing about opioids as though they are the cause of every death and addiction. What about meth, coke, heroin, pot, alcohol or gambling?