Drs. Pohl and Kolodny, I Have Questions About Addiction, Dependency, and Drug Abuse – a rebuttal to PROP doctors from Marylee’s Blog, Says Who??
USA Today recently published an article about seniors and prescription drugs, with input from Dr. Mel Pohl and Dr. Andrew Kolodny to support the claims made in their opinion piece. (See: Seniors and Prescription Drugs: As Misuse Rises, So Does the Toll http://www.usatoday.com/story/news/nation/2014/05/20/seniors-addiction-prescription-drugs-painkillers/9277489/ ) Having read the article, I am left with several unanswered questions. I am herein addressing them to you, Dr. Pohl and Dr. Kolodny.
the statement is made “We didn’t know what addiction was” but you never define addiction –nor for that matter, do you ever acknowledge how addiction differs from dependency, or even from drug abuse.
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. The disease of addiction is a chronic condition that, without treatment, is progressive and can result in lifelong disability or death
Drug dependency, on the other hand, is reversible. Anyone can expect to become physically dependent on a drug they take for a long time; including, for example, diabetic medication, anti-anxiety drugs, sleeping pills, nasal sprays, beta blockers and other cardiac drugs, and many OTC drugs that are NOT prescription medications.
Drug abuse describes behavior born of bad decision-making; not the disease of addiction. Almost all addicts have been physically dependent on drugs, but vastly fewer people who find themselves “physically dependent” on drugs (i.e. pain patients) are addicts.
each patient differs in their perception of pain, in their tolerance for pain, and in their response to medication and treatment
you object to prescription opioid pain treatment but support the use of Tylenol (i.e. Acetaminophen) in patients with severe chronic pain.
My comment – (the blog wouldn’t let me post it)
Marylee, I thank you for this thorough, logical, and wonderfully clear rebuttal to the opiophobic doctrine being pushed by Kolodny and his followers. They all state blatant falsehoods, improperly use statistics, and turn a blind eye to the human suffering cause by untreated pain.
Because their position on the “evils of opiates” supports the current wave of opiate hysteria, their biased statements and twisted facts are promoted by the media and absorbed without question by the public – they are doctors, after all!
However I noticed that, by suspicious coincidence, most of these PROP doctors operate pain clinics. Opioid therapy cuts into their bottom line because, when pain is properly managed, there is no need for potentially damaging physical interventions. Could there be a conflict of interest?
Few patients are warned that these invasive treatments and surgeries can cause permanent damage and some patients are left with even more pain afterward. (Seehttps://edsinfo.wordpress.com/2014/02/25/update-hidden-danger-of-intraspinal-steroid-injections/) All this to avoid a simple, effective, and safe medication, which is only dangerous if used incorrectly (as most other drugs are too).
We need more articulate responses, such as yours, to oppose the barrage of media blather still parroting “drug war” propaganda that’s long been disproven by scientific studies. We need to advance our attitudes and policies about drugs into the 21st century, rather than blindly enforce policies established almost a century ago.