Pubdate: Mon, 27 Mar 2006
Source: News & Observer (Raleigh, NC)
Copyright: 2006 The News and Observer Publishing Company
Author: Mett Ausley, Jr., M.D.


Your March 12 article "Methadone ranks No. 1 in N.C. drug overdose
deaths" accurately depicted methadone as a dangerous drug often lethal
to inexperienced recreational abusers seeking a "high." Your March 14
editorial "Overdose of grief" proposed that the N.C. Medical Board
sponsor training by police to help prescribing physicians recognize
patients likely to divert methadone and other narcotics into
illegitimate channels. While such training would be optional,
untrained doctors duped by their patients would face increased penalties.

Conspicuously absent was any evidence supporting the effectiveness of
this or similar punitive measures in abating overdose deaths from
diverted drugs. Likewise, no consideration was given to possible
adverse outcomes, particularly a further dwindling of physicians
willing to treat patients with chronic severe pain, a debilitating
condition with proven mortality.

Ironically, the spike in methadone overdoses appears an unintended
outcome of a crackdown on OxyContin prescribing a few years ago. The
statistical consequences of undertreated pain might exceed those of
narcotic diversion, but a slow, steady toll of suffering and death
from unrelieved pain doesn't make headlines the way youthful overdose
deaths do.

There's no avoiding risk in medical decisions, including proposals to
put police in doctors' examination rooms. "First, do no harm" applies
to journalists and physicians alike.

Mett Ausley, Jr., M.D.

Lake Waccamaw
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