My patient asked me if I was high!

1. I think having a conversation about non-pharmacological solutions generally take more time and care; in my experience, these conversations are needed, more often than not. I also have chronic pain. Rather than blocking these pains with analgesics, I have chosen to use these experiences as opportunity to discover sustainable solutions for myself and my patients. I try to share these perspectives with my patients in a compassionate way and I find that they are well received.
   
   
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   I just saw a long term opioid reliant patient who I have on daily dispensing. Our non-pharma interventional contract is 20 minutes of meditation daily which she does on her own in my office. At her own request, she gets routine urine drug screen. She show them to her father so that he does not call her names. I encourage her to see her father as someone in need of help rather than one who victimized her. Just now, she pushed her face close to mine and stared into my eyes and waited for me to evaluate her pupil size (opioid state). She told me she is now eating her spinach; she has gained some much needed weight; she even ate some spicy California rolls today! She then told me she is ready to reduce her breakthrough dose. I did a little happy dance as a way of acknowledging her monumental decision! She laughed and asked me if I was high! Lol!