For those of you who have seen my educational presentation on chronic opioid therapy, you know I'm fond of playing a video clip in which Dr. Alan Spanos says, among other things, that opioids are "our best, strongest pain medicines" and that "in fact, the rate of addiction amongst pain patients who are treated by doctors is much less than 1%". He concludes by suggesting that opioids "should be used much more than they are for patients in pain". This usually leads to audible gasps in the audience, many of whom see claims every day that fly in the face of this supposed medical wisdom.
This clip is from a 1998 promotional video produced by Purdue Pharma that highlights the experiences of seven individual patients taking Oxycontin at the time. The Milwaukee Journal Sentinel has just published a very well done "where are they now?" on these seven patients.
Here's a summary of what happened to the seven: "Two of the seven patients were active opioid abusers when they died. A third became addicted, suffered greatly, and quit after realizing she was headed for a overdose. Three patients still say the drug helped them cope with their pain and improved quality of life. A seventh patient declined to answer questions."
As for Dr. Spanos, he's backed down considerably from his original stance on opioids. He now says, "We don't know whether success stories like this are one in five, one in 15, one in 100, one in a thousand. They may be quite rare."
Quite rare, indeed.
Interestingly, Bob Twillman, Director of Policy and Advocacy for the American Academy of Pain Management, posted a link to this article on Twitter. His take on the outcomes for the seven patients? "... film shows that 3 of 6 chronic pain patients had really good results!"
While we can't fault Bob for trying his best to do his job, I can't imagine any rational member of the clinical community taking such a "glass half full" view of these outcomes, particularly when there is no reliable, replicable way to determine which patients will end up with positive clinical outcomes... and which patients will end up dead.
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