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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
VA’s opiate overload feeds veterans’ addictions, overdose
deaths. Sep 28, 2013