3/6/2015, Strong Correlation Between Nonopoid Substance Abuse Disorders and Therapeutic Opioid Addiction
Health care providers face an uneasy dilemma, note the researchers. They must weigh the potential benefits of long-term opioid therapy with the risk of misuse or addiction and yet, according to the researchers, there is “a dearth of reliable information on the prevalence of misuse in those who receive it.”
Gee, I wonder why there is more “reliable” information on drug abuse and addiction than on the benefits of opioid therapy. I wonder if it’s because the NIDA only funds research on the harms of drug use. Or maybe it’s because no one wants to fund a long-term study on opioid therapy, especially during the war against pain patients.
Age and sex appeared to be an important factor, with young males being particularly susceptible to developing TOA. Marital status did not appear to be related to TOA development…
If you are a “young male” in chronic pain, you’re probably being discriminated against. You’re being profiled. The high suicide rate in this age group suggests that their pain is being under-treated.
They also noted that their study did not address the question of whether higher doses of opioids lead to addiction or rather that addiction leads to higher doses…
Patients who do not achieve substantive benefit from opioid prescriptions should be transitioned to other treatment…
What kind of benefit would be acceptable? Who decides if the patient is obtaining substantive benefits — the doctor, insurance company, or the DEA? What if the patient is achieving moderate rather than substantive benefits? Do doctors and insurance companies believe that opioid therapy for chronic pain patients is some kind of cure?
This study underscores the need for the proposed screening tools in the treatment of workers’ compensation patients. There can be little question that the appropriate use of opioid drugs to treat chronic injuries in the Workers’ Compensation System continues to be a serious problem.
The screening tools are used to support the denial of prescription medications.
In 2014, the California Division of Workers’ Compensation posted proposed treatment guidelines for the use of opioid medications in the treatment of workers’ compensation patients. Those proposed guidelines specifically recommended the use of screening tools to identify a predicted increased risk for substance misuse/abuse. In those cases, the guidelines indicated that chronic opioid treatment should only be initiated if other alternatives are not viable.
So, if you live in a state that doesn’t have a medical cannabis program, you get to choose opioid treatment?
The following are real life examples of workers’ compensation patients who had a prior substance abuse problem and what happened when they were prescribed opioids to treat pain for their injuries…
The judge in the case stated that the employee was “drug-seeking before his injuries and is drug-seeking now.” The judge found that the employee had not met his burden of proving that the work injury caused aggravation of his mental condition or his drug abuse propensities…
Oh, it’s a judge who decides if a pain patient is drug-seeking or just treating his pain.
The judge credited this psychiatrist’s explanation of the decedent’s death and concluded there was no persuasive evidence to establish that the decedent’s work-related knee injury aggravated or accelerated his mood disorder or otherwise caused the overdose. The judge therefore denied the claims for death benefits.
Judges are now doctors. Insurance companies and the DEA are now judges and doctors. I guess anybody can play doctor these days.