The Pendulum Swings for Opioid Prescribing

von Gunten Charles F. and Editor-in-Chief. Journal of Palliative Medicine. April 2016, 19(4): 348-348. doi:10.1089/jpm.2016.0079.

Published in Volume: 19 Issue 4: April 1, 2016

I am about to turn 60 years of age. During my professional life as a physician, I have seen the pendulum of attitudes about the role of opioids for treating pain swing its full arc and back again. I only graduated from medical school in 1988! Why does the pendulum need to swing from one extreme to the other? Why can’t it settle in the middle, at rest, where it belongs? …

But now, a generation has passed. The newspapers are full of stories of the number of deaths from prescription opioids rising precipitously. It seems to me they are making the same mistake—looking at those abusing the drugs and falsely imputing causation: the drugs caused the addiction. The numerator and denominator are wrong again. The politicians are in a hurry to be seen to be “doing something” and new laws and restrictions on prescribing are multiplying. I see the chilling effect on all prescribers every day. The meta-message to physicians is clear—be very afraid if you prescribe any opioids to anybody or you will cause them to be an addict and die. Better to let the patient suffer than be suspected of causing a rise in the number of addicts and opioid-related deaths. The pendulum is hurtling back to the place it had in 1940.


2 thoughts on “The Pendulum Swings for Opioid Prescribing

    • Yes, but most people eventually learn from their mistakes. Government, on the other hand, seems to operate on another plane of existence, repeating the same tragic mistakes over and over again… No wonder conspiracy theories are so popular.

      Liked by 1 person

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