Posted by Sulpicia on June 23, 2001, at 23:06:20
In reply to Re: Addictive meds in general:Gdog, Gilbert JCB, posted by JCB on June 22, 2001, at 22:24:27
> JCB --
sorry about the tone and I didn't mean to challenge your credentials. It's unfair to expect perfection about such a complicated issue as addiction.
Now, granted that I'm unfamiliar with your patient population, it seems like the face of addiction is becoming more complex. People with chronic pain have long been plagued with addiction but one cannot simply withdraw them from opiates and substitute nsaids or massage: as medicine advances [some might use another verb] one of the costs is that many people survive major problems but live with chronic pain. If the pain is not relieved, and in some cases only opiates will do so, they will surely relapse. Many conditions are part of the self-medication-to-addiction/abuse dynamic, and these conditions MUST be treated if the patient is to have any hope of recovery or quality of life.
I take your point about meds being used as a crutch but please remember there is not one shred of research that demonstrates talk therapy without effective pharmacology has any efficacy whatsoever on disorders such as chronic severe depression, biopolar disorder, or ADHD -- I could probably think of more too.
And you know the cormorbity statistics as well as I do -- it is statistically impossible that the majority of your clients do not have one or more of these disorders.
Much like those recovering from eating disorders who must constantly face the substance they abuse, addiction treatment *needs* to accomodate the realities of psychiatric illness, and treat the patient accordingly. I don't envy you the complexity of your job.
Thanks for an interesting discussion.
And just for the record, benzo withdrawal is done inpatient because of the risk of seizures, which can be fatal, right??
S.
poster:Sulpicia
thread:1356
URL: http://www.dr-bob.org/babble/20010618/msgs/67626.html