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Making a U-turn: Clinical Applications of Opioid Guidelines April 6, 2017

U-turn: Clinical Applications of Opioid Guidelines April 6, 2017 Andrew Kolodny, MD No financial relationships to

Andrew Kolodny, MD

No financial relationships to disclose

U-turn: Clinical Applications of Opioid Guidelines April 6, 2017 Andrew Kolodny, MD No financial relationships to
Source: Purdue Pharma budget plan obtained from litigation
Source: Purdue Pharma budget plan obtained from litigation
Source: Purdue Pharma budget plan obtained from litigation

Source: Purdue Pharma budget plan obtained from litigation

Source: Purdue Pharma budget plan obtained from litigation
In March 2003, the VA & DOD issue one of the first guidelines on opioid

In March 2003, the VA & DOD issue one of the first guidelines on opioid use for chronic pain.

In March 2003, the VA & DOD issue one of the first guidelines on opioid use
 For many patients opioids are “the most effective option.”  Concerns about addiction, tolerance,

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.”

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“No pharmacological rationale for using a predetermined maximal dose .”

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
Source: The Center for Investigative Reporting VA’s opiate overload feeds veterans’ addictions, overdose deaths. Sep

Source: The Center for Investigative Reporting VA’s opiate overload feeds veterans’ addictions, overdose deaths. Sep 28, 2013

Center for Investigative Reporting VA’s opiate overload feeds veterans’ addictions, overdose deaths. Sep 28, 2013