Quote:
Originally Posted by SupDock
I am not talking about drug seeking behavior because that is extremely hard to study. I am talking about risk of developing an opiate dependence, which goes up the longer you are on the medication and which the study clearly demonstrates.
Opiates have consistently failed to demonstrate long-term benefit in chronic musculoskeletal pain, which is why as a prescribing physician I'm trying to minimize the risk that a patient will end up dependent on the medication long-term. from a prescribing point of view there is little reason to distinguish between the two situations. My goal is for my patients to not be on chronic opiate therapy for musculoskeletal pain, because their use in this situation is not evidence driven. I am not discounting the fact that in a small minority of patients it will be necessary to be on opiates long-term for their musculoskeletal pain, merely stating that this is the exception rather than the rule.
also, 30 days or more is not consistent with what you said. Will you please address the fact that you said this takes "months or longer" to develop opiate dependence. This is the crux of my disagreement with you
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I see our disagreement. OP asked about becoming 'addicted'. In my experience, 'addiction' = 'drug-seeking behavior'. In your experience, dependence can be addiction. If someone is merely dependent, they might not display or develop drug-seeking behavior. I would agree that dependence does not equal drug-seeking behavior and given that dependence does not create the risk of criminal prosecution or DEA interest, and that dependence, while not healthy, does not create the health risks of drug-seeking behavior*, it is much lower on my radar.
As far as "months", that is likely because its a term of art in my business. 31 days would be 2 months because it has rolled over into a second month. 61 days would be 3 months, etc. For one, as stated above I am focused on drug-seeking behavior as opposed to dependence, which I anticipate would take longer. Second, months could be two months, short as 31 days, or 4+ weeks. I regret the confusion.
* I don't see those with a drug dependence engaging in various risky behaviors, such as needle-sharing, prostitution, or cutting drugs with non-safe substances, such as lye.