, Volume 24, Issue 9, p 1082
Date: 30 Jun 2009


This is an excerpt from the content

Authors Reply:—We appreciate Dr. Rastegar’s observation that the focus of his opioid prescribing has changed over time and agree that this raises an intriguing question. While we know of no empiric evidence to support or refute the association between greater experience and use of a decision making framework that focuses on addiction, we fully agree that decision-making frameworks may not be static. In fact, we suspect that many physicians may have changed the focus of their pain treatment relatively recently. Approximately 20 years ago, pain specialists argued that the risk of addiction should not prevent the use of prescription opioids to manage chronic pain, and there was a shift in clinical consensus in favor of using opioids for pain. Consequently, rates of opioid prescribing increased dramatically,1,2 and there were substantial increases in drug-related emergency room visits, admissions to addiction treatment, and deaths from drug overdose.3,4,5 If greater experience is associate ...