When “Responsible Prescribing” Becomes Cruelty

Meet “Kiarra” – And the Uncomfortable Truth

Let this be grounded in reality.

Kiarra is a child.

She recently underwent surgery to repair a fractured bone. Pins were placed. This was not a scraped knee or a routine dental procedure. This was orthopedic surgery involving metal, force, and trauma.

The surgeon sent her home with no narcotic pain medication. None. Zero. The justification was familiar and hollow: “Her pain levels should be treatable with Tylenol and Motrin.” What they really meant was “We don’t want to contribute to opioid misuse.”

The outcome was entirely predictable.

Hours later, Kiarra was in agony. This was not mild discomfort or routine soreness. This was severe, unrelenting pain. The kind that leaves children crying until exhaustion takes over. The kind that pushes parents into panic.

What followed was a bureaucratic obstacle course:

• frantic phone calls
• a CVS with a downed system
• multiple refusals
• escalating frustration
• wasted hours

Only after sufficient suffering—after the pain had proven itself undeniable—was she finally “granted” oral oxycodone.

“Granted” as though pain relief were a privilege; as though suffering were part of the care plan, or a necessary prerequisite before sufficient pain medication was prescribed.

This never should have happened. It’s happening everywhere.

Let’s Be Honest About What This Is (And What It Isn’t)

This policy is marketed as harm reduction. It is not.

It is framed as responsibility. It is not.

It is presented as a solution to illicit opioid use. It is not.

Here is a truth the medical establishment, the DEA, and anti-opioid zealots keep avoiding:

Post-operative pain management has virtually nothing to do with illicit opioid addiction.

People do not become heroin users after receiving a short, medically supervised course of pain medication for acute surgical pain. That narrative has been debunked repeatedly. Its continued use reflects ignorance, willful dishonesty, or medical activism.

Illicit opioid use is driven by:

• untreated or abandoned pain
• forced tapering and abrupt discontinuation
• contaminated street supply
• prohibition and fear-based prescribing
• patients pushed out of care and into desperation

None of those causes involve a child receiving appropriate pain relief after metal is drilled into her bone.

Conflating these realities is not caution.

The central lie being told to countless patients (and their parents) deserves to be dismantled directly.

Denying post-operative pain medication does not prevent addiction. This holds true statistically, clinically, logically, historically, and in practice.

Large-scale studies consistently show that the rate of new opioid use disorder among opioid-naïve surgical patients prescribed appropriate post-operative pain medication is well under 1%. Most patients take the medication, heal, discontinue use, and return to their lives without incident.

The individuals at real risk for addiction tend to be those who are:

• left in unmanaged pain
• forced to beg, bargain, or wait
• pushed outside the medical system
• exposed to an unregulated and contaminated drug supply

These policies create precisely those conditions.

If addiction prevention were the true goal, the solution would be obvious:

• treat pain early and adequately
• prescribe the lowest effective dose for the shortest necessary duration
• educate patients instead of punishing them
• keep pain management within the medical system

The current approach does the opposite, then feigns surprise when outcomes worsen.

Illicit opioid deaths did not surge due to generous post-operative prescribing. They surged after crackdowns, prescription fear, and the mass abandonment of patients who still hurt met the contaminated street supply of fentanyl (and worse).

Withholding pain medication after surgery is not prevention.

It is optics.
It is liability theater.
It is institutional fear dressed up as public health.

Real people like Kiarra pay the price.

Pain Is Not a Moral Failing

Suffering is not treatment.
Denial is not care.

At some point, pain itself became suspicious.

Patients in pain are now interrogated, doubted, and minimized. Relief must be earned. Suffering must be demonstrated. Endurance is praised. Requests for help are quietly reframed as moral weakness.

This is medieval thinking in a lab coat.

Antibiotics are not withheld to discourage infection.
Anesthesia is not denied to deter surgery.
Patients are not left screaming to “send a message.”

Opioids are the lone exception.

Cruelty becomes courage the moment fear replaces judgment.

The Barbarism Hiding Behind Policy

Strip away the language and the reality becomes unmistakable:

• surgeons knowingly send patients home in severe pain
• children are included in this experiment
• families are forced into crisis mode
• relief is delayed until suffering becomes undeniable
• institutions congratulate themselves for being “tough”

This is not evidence-based care.

This is pain as deterrence.

The policy fails at its stated objective while succeeding at one thing only: hurting innocent people.