The heroin epidemic – some thoughts

As a medical student and resident, I saw many heroin addicts.  We got used to managing right sided endocarditis and overdoses.  That epidemic diminished greatly until recently.  Susan Collins points out the likely source of the current epidemic – Susan Collins cites possible tie between hospital patient surveys, overprescription of opioids. “In the meantime, however, we are concerned that the current evaluation system may inappropriately penalize hospitals and pressure physicians who, in the exercise of medical judgment, opt to limit opioid pain relievers to certain patients and instead reward those who prescribe opioids more frequently,” the letter added. As often happens, bureaucracies create rules without carefully considering the unintended consequences of those rules.  If they had consulted practicing physicians about this emphasis on pain control, perhaps the physicians would have predicted this consequence.  “But the letter questions whether pain management should be part of the equation. Four of five new heroin users were first addicted to prescription opioids, according to the National Council on Drug and Alcohol Abuse.” So what should we do?  Here is a radical idea.  We should test medical marijuana as an alternate management strategy.  Many studies are addressing this issue.  Here is a reference that gives mixed results – JAMA Meta-analysis Finds Mixed Results for Medical Marijuana Use Marijuana does have complications, but th...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs