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Gen Hosp Psychiatry. 2014 Jul-Aug;36(4):449.e1-2. doi: 10.1016/j.genhosppsych.2014.03.007. Epub 2014 Mar 18.

Putting a face on the prescription opioid epidemic: a case report.

Author information

1
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. Electronic address: jacob.taylor@jhmi.edu.
2
Johns Hopkins University School of Medicine.
3
Berman Institute of Bioethics, Johns Hopkins University, and Division of General Internal Medicine, Johns Hopkins University School of Medicine.
4
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine.

Abstract

Skilled clinical decision making in the diagnosis and treatment of chronic pain can create unique clinical and ethical challenges, particularly when opioid medications are involved. This report presents the case of a pregnant woman who sought treatment for an illicit opioid dependence, initiated by opioid analgesic treatment of chronic pain. While recognizing opioids' high level of effectiveness for pain relief, the case demonstrates the potential harms of opioid medications for particular patients. Using a framework informed by medical ethics, the report discusses how clinicians might assess the benefits and risks of opioid treatment by careful data gathering, knowledge of the evidence base and patient-centered, shared decision making.

KEYWORDS:

Ethics; Opioid dependence; Prescription drug dependence

[Indexed for MEDLINE]

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