11/21/2014, Treating Pain Patients Like Addicts

http://jamespmurphymd.com/2014/11/21/treating-pain-patients-like-addicts/

If not addiction, then what is this complex neuroadaptation to long-term exposure to opioids? In a 2012 commentary article from JAMA Internal Medicine, Doctors Ballantyne, Sullivan, and Kolodny referred to it as “complex persistent opioid dependence” (JAMA Internal Medicine September 24, 2012, Vol 172, No. 17):

Dependence on opioid pain treatment is not, as we once believed, easily reversible; it is a complex physical and psychological state that may require therapy similar to addiction treatment, consisting of structure, monitoring, and counseling, and possibly continued prescription of opioid agonists.

But I am suggesting, as do Doctors Ballantyne, Sullivan, and Kolodny, that the better therapeutic approach may be to view their care through the lens of Addiction Medicine in addition to that of Pain Medicine.

_____

And so you can see, the Pied Piper of Addiction Medicine (not a real medical specialty), Andrew Kolodny, has hypnotized other doctors into believing that pain patients should be treated as addicts — because there is an awful lot of money in a whole new patient population.

I found this link on a the Kentucky Pill Mill facebook page, and it appears they follow Dr. Murphy and agree with his writings.  And if I were to guess, it’s because Dr. Kolodny has created a new condition for pain patients — complex persistent opioid dependent patients (“CPOD”) — which consists of “possible” treatment with continued opioids.  Of course the condition is is not “easily reversible,” and includes long-term (expensive) treatment.

Heck, most pain patients don’t care what you call it, they just want adequate treatment.  You want to say I have CPOD and will treat me with opioids?  Instead of treating my pain with opioids?  Sure, fine, whatever.

I have no doubt that there are some pain patients on opioid therapy who might benefit from being treated for addiction or “CPOD,” but it’s a very small percentage.  Nah, this won’t help most pain patients — it only labels them — for life.

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