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Making a U-turn: Clinical Applications of Opioid Guidelines

April 6, 2017

Andrew Kolodny, MD

No financial relationships to disclose


Source: Purdue Pharma budget plan obtained from litigation
In March 2003,
the VA & DOD
issue one of
the first
guidelines on
opioid use for
chronic pain.
For many patients opioids are the most effective option.

Concerns about addiction, tolerance, and dependence are


described as barriers to appropriate care.

Repeated exposure to opioids . only rarely cause addiction.

No pharmacological rationale for using a predetermined


maximal dose .
Source: The Center for Investigative Reporting
VAs opiate overload feeds veterans addictions, overdose
deaths. Sep 28, 2013

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