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June 14, 2000

Medical Treatment of Opiate Addiction—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(22):2931. doi:10.1001/jama.283.22.2931

In Reply: The NIH Consensus Development Panel was convened to develop a consensus statement on the effective medical treatment of individuals who illegally abuse and are addicted to opiates. It is difficult for us to find Dr Aronoff's argument relevant since patients with chronic pain being treated with opiates under close medical management were never a focus of the NIH consensus panels, nor were they ever mentioned in the consensus statement.

The consensus panel focused exclusively on the urgent serious public health and social problems that are presented to US society by illegal opiate abusers and addicts. A careful review of the contents of the statement—which ranged from providing the history of illegal opiate abuse and addiction in this country to making recommendations for change in the Office of National Drug Control Policy and federal regulations—will show that it concentrated completely on the illegal use of opiates and their sequelae and on the effective medical management of these patients. Thus, patients with chronic pain being treated medically with opiates, who may or may not be dependent on those medications, were not the charge of the panel nor were they considered in its deliberations and conclusions.

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