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The Paradocs Podcast with Eric Larson

The Paradocs is a fun and lively discussion with a couple of docs on the practice of medicine. Occasionally serious, usually lighthearted, and accidentally informative. A show for physicians to learn more about what is going on and a great place for them to direct their friends and family to better understand the challenges they face.

Nov 8, 2018

The opioid crisis has been in the news for a few years now and those to blame for it are many. Is it pharmaceutical companies who made easy to prescribe formulations of powerful pain killers? Is it physicians for over prescribing pain medicine for simple aches and pains? How about federal guidelines that encouraged the over treatment of pain? Or the creation of the fifth vital sign in the late 90's that treated pain as important as heart rate.
In this conversation, Dr. Grattan and I will discuss who we think is to blame in this crisis which made it all the way into popular television and presidential politics. Not surprisingly, physicians have been labeled the scapegoat in this problem despite decreasing the rate of prescription writing in 2011 - before the opioid overdose problem even began in 2013. Without a doubt, physicians are somewhat to blame in the development of some of the overtreating of pain with opioids by helping establish guidelines encouraging other doctors to write ever escalating doses of opioids.
Unfortunately, state legislation has focused on punishing doctors while sending mixed messages. Doctors were getting sued successfully in the late 90s for a failure to adequately treat pain with opioids. Less than ten years later they were getting charged with murder when their patients overdosed on opioids. This has led most physicians to abandon treating pain with opioids altogether leaving pain clinics swelling with patients or patients hitting the streets to treat their dependence with heroin and illicit fentanyl.
We will discuss the causes of this crisis in more detail in the episodes, solutions, harmful legislation, and maybe a little bit about whether or not Portugal's 10+ year experiment to decriminalize drugs is wise or not.
  Dr. Howard Grattan is a PM&R physician specializing in pain at the Columbia Pain & Spine Institute in Portland, OR. He is an expert in treating patients with opioid dependence.


show notes

Columbia Pain & Spine Insitutue: Dr. Howard Grattan's practice in Portland, OR.

10 Years After Decriminalizing Drugs: Forbes article from 2011 about the Portugal experiment cutting drug abuse in half by decriminalizing.

Memorial for Andy Larson: This is the donation link to honor Andy's death with the Grand Rapids Choir of Men and Boys where he blossomed and served as a head chorister.

YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.

Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.

Listen to The Paradocs on RadioPublic