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I was denied sedation/effective pain meds before a procedure pretty recently. Despite the fact that I spent the entire time literally screaming in pain, they dismissed it as “anxiety” and did nothing to help.

I also received very little when I first came into the hospital - as my body was flooding with literal shit and I was fucking dying. They let me writhe and roll around for hours before they mercifully knocked me out for my operation.

I’m traumatized to the point where watching movies where people experiencing pain is upsetting. I was watching fucking Avatar the Last Airbender and wincing every time someone got punched or kicked.

I also go back to getting my IUD put in - again, another extremely painful procedure that is “not supposed to hurt” so there is no option for sedation or effective pain meds.

It feels like asking for pain meds gets you labeled as a drug seeker/addict too. I made the mistake of mentioning that I smoke weed (because I knew the anesthesiologist needs to know that) and it feels like it was instantly assumed that I’d be a pill popper too.

And I have extremely high pain tolerance. I’ve literally had people whip me until they’ve drawn blood. I’ve worked a fast food shift with a second degree (even a bit of third degree) burn going down the majority of my arm. I’m not a wuss, I know how to breathe in ways that help, I know how to go to a mind palace, but Christ, when you start digging around in someone’s guts with sharp objects, that’s not really something you can meditate away!

Is it training? Is it the fact that becoming a doctor in the U.S. requires the kind of upper middle class upbringing that doesn’t tend to help people develop empathy?

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[-] Apytele@sh.itjust.works 18 points 18 hours ago* (last edited 17 hours ago)

I'm going to mostly focus on the more legitimate answers since you already seem to know some of this was possibly / probably oversight / neglect and that they should have given you more.

a) the big one is pressure from regulatory agencies to prescribe less narcotics. Some of this is legitimate; a lot of the opiate crisis was started by pharma companies lying about how habit forming their medications are and intentionally encouraging dependency through overprescribing to sell more, but a lot of it is also just straight up puritanical and part of efforts to disrupt minority communities that are more affected by illicit drug use. In the end though, even if they don't share the stigmatizing view of it, there's little individual prescribers can do about it.

b) there's huge pressure in institutional environments to do ANYTHING to prevent falls. In addition to getting stingy with sedatives that might make you dizzy there's also pressure to have 1:1 care where people watch the patient in the bathroom and we used to even restrain old people to keep them from falling (although thank goodness that's finally falling out of favor). To get rid of that we'd have to accept that sometimes people just fall and crack their head open and die and that's life but we're just not there yet as a society. In the US everything needs to be someone's fault and if the doctor prescribes a sedating med and I give it and you fall, it's partially considered my and the doctor's fault. If we do ALL the environmental AND don't give sedating meds, it's considered less our fault.

c) There's legit specific medical reasons sometimes. If you had a bowel obstruction opiates are actually specifically contraindicated since they're the medications MOST likely to cause constipation. Now if surgical intervention was the best option it might make sense to give them anyway, but there may have been some waffling on what the best option was and they couldn't un-give you the meds if the final decision was to have you pass it with medication / enemas instead of surgery. And bowel surgeries have a huuuge possibility of sepsis and having to parts of the bowel removed and having to get regular vitamin shots for the entire rest of your life (once had a bypass patient so iron deficient she stated hallucinating) so that's not a decision to make lightly.

d) insurance in the inpatient environment likely didn't interfere with the medication prescription directly. they probably DID interfere with the surgical decision which may have interfered with the medication decision (see above). but the bigger issue is that insurance agencies in general do something waaay more insidious than just avoiding paying. they create and fill a psychological need to find someone to blame for things. every time something bad happens in the US we immediately try to figure out who to blame so we know who's paying for it. this is your health but also to your house and your car. the insurance is there more than just to pay but also to pay court fees if the blame isn't immediately placeable. if I give you a sedating medication and you fall, the insurance doesn't pay for it they make the hospital pay for it. So as a result the hospital pressures me to not give you that medication so you don't fall and leave them with the bill. to truly be rid of insurance companies in general we would have to fundamentally move away from blame culture. we would have to shift to a mindset of, wow that's horrible but we as other humans are going to take care of you. and like I said, we're just not there yet (but universal healthcare is definitely a step in the right direction; that kind of change can't start with individuals struggling to make rent).

this post was submitted on 23 Jun 2026
116 points (90.8% liked)

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