Word: volkow
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...Nora Volkow, director of the National Institute on Drug Abuse, takes a more sober view of the findings, pointing out that 18 of the 26 studies in Noble's review failed to mention addiction. The review authors say they assumed the omissions meant that those studies did not find any cases of addiction, but Volkow says it could mean that they simply didn't look for it. (See pictures from an X-ray studio...
...Still, Volkow does not deny that age and prior addiction are key risk factors for drug problems; addiction is primarily a disorder of youth. Based on this review and other research involving middle-aged or older people screened for pre-existing drug problems, Volkow says, "Under those conditions, you can say that the risk [of addiction] is less than 3% [in people with no history of drug abuse...
...suicide attempts, while others were due to patient error, but the study could not identify exactly what went wrong in all of the cases. Was it the high-prescribed dose alone, or were there other risk factors like illness, escalation of pain or undiagnosed addiction? While Von Korff and Volkow agree that prescription dose is a major contributor to overdose risk, they say better studies are needed to determine the precise causes and consequences. "One would hope that for a treatment regimen that millions of people are using, we'd have large, long-term, well-designed randomized controlled trials...
Paradoxically, the findings suggest that the use of opioids could even help prevent addiction by reducing the risk of a psychological condition that is known to lead to substance misuse. "PTSD is so devastating, and it increases the likelihood of addiction," says Volkow. "I think it's definitely worth investigating...
...much murkier, research suggests that still only a fraction of such patients receive the medication they need. While in some cases, doctors are using these powerful drugs too often, in others, concerns about misuse may have caused pain patients to suffer unnecessarily. "There is both overprescribing and underprescribing," says Volkow, who notes that, for instance, many dentists give opioids like Percoset too freely to teenagers after surgical procedures; in contrast, "you have individuals with very severe pain who are not given opioids or who are given doses that are [too low to treat the pain], and that...