Doctors partly to blame for opioid addiction
https://www.theguardian.com/science/2017/may/10/doctors-partly-to-blame-for-opioid-addiction Version 0 of 1. Only a week ago I told a patient there would be a scandal soon about our over-prescribing of opioid medication for chronic pain. What comes across in your article (Doctors call for action after prescriptions for addictive painkillers double in decade, 6 May) is the absence of any sense of the profession’s complicity in this process. I suggested to a colleague a few years back that we prescribed too much Valium (diazepam) and opioids. “About the same as everyone else,” was the reply. We are effectively legalised pushers and should acknowledge this because, in doing so openly with patients, we shoulder some of the blame for their habit. I also remember helping a woman in her 50s wean herself off diazepam, alcohol, co-codamol, antidepressants and cigarettes after 30 years of using these to block the pain of her second son being born with cerebral palsy and being taken into care. It was a struggle for her but it brought her back into her relationship with her husband: a few months later he tearfully related how he had re-met the woman he married 30 years before. This was only possible – I believe – because, at the outset, I said that it was we doctors who were responsible for her addiction.Dr Hugh van’t HoffGP, Stonehouse, Gloucestershire, and director of Facts4Life • As someone living with lifelong chronic pain, I was interested to read your article highlighting that opiate use had doubled in the last decade with associated risks of addiction and dependency. While I agree this is worrying, I would argue that it reflects the dominant biomedical model of pain management within the NHS. There is little or no science involved in matching an individual patient with the complex range of painkillers available. It is largely a case of try it and “see how you get on”. I have been on dozens of painkillers, including opiates, throughout my life. I found most have unbearable side-effects and limited impact on my pains. We need a holistic approach to pain that can offer comprehensive individual assessments and access to a wide range of treatments. Opiates and other painkillers can have an important but not a primary role in pain management.Martin HobanPontyclun, Rhondda Cynon Taff • Join the debate – email guardian.letters@theguardian.com • Read more Guardian letters – click here to visit gu.com/letters |