Pain Management

Amid concerns of necessity and abuse, EMS struggles to deal with patients’ pain.

By Jenifer Goodwin, associate editor

One recent evening in Denver, a man known to EMS to have a history of drug abuse was brought by ambulance to Denver General Hospital after being hit by a car. A bone in his arm was poking through his skin, but paramedics didn’t give him pain medication. “We’re familiar with him. He likes his drugs,” Christopher Colwell, M.D., an emergency physician and medical director for the Denver Fire Department and Denver Health Paramedic Division, recalls medics telling him.

Colwell was appalled. The man was obviously in severe pain, yet he was being denied relief because of his drug dependency status. “It was astounding. Here was someone with a bone sticking out of his arm, whose pain should have been treated,” he says. “Yet medics were not able to step out of that and treat the patient based on his current situation rather than his history.”...

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