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Researchers have found that a one paragraph letter to the New England Journal of Medicine in 1980 was "uncritically cited as evidence that addiction was rare with long-term opioid therapy" [emphasis in original retained]:
Canadian researchers have traced the origins of the opioid crisis to one letter published almost 40 years ago.
The letter, which said opioids were not addictive, was published in the New England Journal of Medicine (NEJM) in 1980.
Dr David Juurlink says the journal's prestige helped fuel the misguided belief that opioids were safe.
His research found that the letter was cited more than 600 times, usually to argue that opioids were not addictive.
On Wednesday, the NEJM published Dr Juurlink's rebuttal to the 1980 letter, along with his team's analysis of the number of times the letter was cited by other researchers.
The two names to blame? Dr. Hershel Jick and his assistant Jane Porter. Dr. Jick did not anticipate the misuse of his short letter:
Jick still works at Boston University School of Medicine. He told the Associated Press this week that he is "essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did."
"They used this letter to spread the word that these drugs were not very addictive," he said. Jick noted that he testified as a government witness in a lawsuit some years ago concerning the marketing of pain drugs.
A 1980 Letter on the Risk of Opioid Addiction (DOI: 10.1056/NEJMc1700150) (DX)
Addiction Rare in Patients Treated with Narcotics (DOI: 10.1056/NEJM198001103020221) (DX)
(Score: 2) by VLM on Sunday June 04 2017, @05:11PM (1 child)
I read both letters, the original and the response, and they're apples and oranges comparisons.
The most striking observation is the original letter specified patients in the hospital. So, setting a broken leg or surgery or cancer hospice care.
Whereas the response letter specifically defines the problem as outpatient long term use.
I think its very likely both letters do not conflict and are simultanously true.
It sounds extremely realistic that giving a terminally ill hospice patient an injection in their last week of life or giving a little kid an injection while their broken leg is set into a cast will not result in long term addiction. While at the same time sending someone home with a bottle or two of pills and medical instructions that they are not medically cleared to do anything but get high and watch daytime TV is probably going to turn them into a raging addict.
Just look at the setting alone; one scenario associates getting high with dying, broken bones, car accident, burn unit, not really positive stuff. The other associates getting high with partying at home and watching TV. Hmm. Getting high in the burn unit after the fire accident or getting high watching anime at home, I wonder which makes more addicts LOL.
(Score: 1, Informative) by Anonymous Coward on Sunday June 04 2017, @11:31PM
Along with this has been the development (and/or commercialization) of very high potency opiates. The latest stuff from big pharma is orders of magnitude more potent than heroin (a patent medicine ~100 years ago) and morphine.