Editor's Correspondence
May 09, 2011

A True Believer’s Flawed Analysis

Author Affiliations

Author Affiliations: Department of Neurology, Memorial Sloan-Kettering Cancer Center (Dr Foley), and Departments of Medicine (Dr Fins) and Pharmacology (Dr Inturrisi), Weill Cornell Medical College, New York, New York.


Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Intern Med. 2011;171(9):867-868. doi:10.1001/archinternmed.2011.166

The editorial by Mitchell Katz1 describes his frustration in caring for patients with complex pain along with medical illness and substance abuse problems. He argues against the recommendations for careful assessment and monitoring contained in the recently published evidence-based guidelines for the use of opioids in chronic noncancer pain.2 Rather, he suggests that these recommendations interfere with the physician-patient relationship and facilitate the physicians' distrust of the patients' compliance with opioid therapy. Instead, he calls for consensus guidelines to establish a maximum dose for long-term treatment of chronic noncancer pain with opioids. He bases this in part on the dosage levels he estimates from the Braden report,3 which we were unable to confirm from the report and suspect that Katz overestimated the doses.

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