This is one in a series of physician stories collected by Consumer Reports to share how conversations about Choosing Wisely are making a difference in patient care.
Mark Baker, MD
Emergency Medicine Physician, Hawaii
“We had a woman who was coming into our emergency department pretty frequently with abdominal pain. I have no doubt that she truly did have abdominal pain – she was in overall poor health, had renal failure, and diabetes – but there was no clear explanation for the cause of her pain.
At some point along the way, she started getting opioids to control her pain. And, as is often the case with many patients, she started getting more and more opioids and visiting the emergency department more and more frequently.
As her visits began increasing, I talked to her about opioids being addictive. I tried to explain in very simple terms that if she kept taking opioids, her tolerance to them would build up and they would then no longer work. As this happened, she would then likely want to start taking more and more of them to get the same effect.
I suggested at that visit that we give her one more shot, but then we stop. I also gave her an educational brochure that Consumer Reports created as part of the Choosing Wisely campaign. It talks about the serious side effects and risks of opioids, including the fact that they can lead to addiction. She read it over and seemed receptive to it.
A couple of weeks later, I saw her again in the emergency department, still for abdominal pain. She looked at me and said, “Doctor Baker, I’m off opioids and I don’t want any more.”
She’s since needed some, but she’s decreased using them from about six times per month to every other month. It seemed like she really read that Consumer Reports brochure and realized that she didn’t want to become addicted.
Some doctors and educational brochures shy away from using the word “addiction,” but I talked to her about it and she also read about it in that brochure. And maybe it was that concept – she didn’t like the thought that she could be or was addicted to something – that shifted things for her.”