In the pain control community,Demerol4,5 is known to be distinctively inferior with a short duration of action, local irritative property, and a toxic metabolite, normeperidine, which can cause delirium and seizures6 in effective analgesic doses. The need for change in pain control in the wider medical and nursing community seems to be met with apathy and confrontation. Health professionals believe that their patients have good pain control so they are apathetic about need for change. Proposals for improved pain control all too often are met with confrontation. Indeed the emperor has no clothes.
Pain control is poor but the old methods are so familiar.
Change is needed but inertia is difficult to overcome. The momentum would then allow for other needed changes in the mystical pain book. Patient centered pain assessment, round the clock rather than prn dosing, rescue doses for unrelieved pain can all become common practices. DFZ is a positive first step to start nation wide meaningful change is the reduction of pain. Global changes must begin locally.