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J Gen Intern Med. 2009 September; 24(9): 1081.
Published online 2009 June 9. doi:  10.1007/s11606-009-1038-1
PMCID: PMC2726878

Providers’ Experiences Treating Chronic Pain Among Opioid-Dependent Drug Users

To the Editor:—Dr. Berg and colleagues provide interesting insights into the dilemma of treating pain among patients with co-morbid addiction.1 They found a dichotomy and tension between a decision-making framework that focused on abuse (framework 1) and another that focused on treating pain (framework 2), and report that most providers adhered to one or the other. I have also observed this dichotomy, but I suspect that the decision-making framework of providers is not always static. Over time, I find myself moving from framework 2 (focused on treating pain) toward framework 1 (concerned about abuse). I realize that the number of providers in this study was fairly small, but I wonder if the authors found a similar trend among their providers, i.e., were the providers who were more concerned about abuse (framework 1) older or more experienced than the others?

Reference

1. Berg KM, Arnsten JH, Sacajiu G, Karasz A. Providers’ experiences treating chronic pain among opioid-dependence drug users. JGIM. 2009;24(4):482–8. [PMC free article] [PubMed]

Articles from Journal of General Internal Medicine are provided here courtesy of Society of General Internal Medicine