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Acknowledging stigma: Its presence in patient care and medical education.

Elaine is a 48-year-old woman with chronic pain due to fibromyalgia and postsurgical pain, and she has been prescribed opioids for this pain for a number of years. Elaine works full-time and has followed all the recommendations made by her family physician. She exercises regularly and has participated in the Chronic Pain Self-Management Program. She has been honest with her family doctor that she uses small amounts of cannabis to help her sleep, but has exhibited no concerning behaviour. However, she missed her last appointment with her doctor as a result of the sudden unexpected death of her mother, and has now run out of her medication. She presents to the emergency department asking for a refill and is scolded by the emergency physician, who gives her a few days’ supply of medications and tells her to see her own physician. On her way out of the emergency department, Elaine overhears another staff member saying to the physician, “Another drug-seeking addict clogging up the system.” When Elaine sees her family physician, she expresses how shamed she felt by this encounter.