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From: dyer@spdcc.UUCP (Steve Dyer)
Newsgroups: sci.med
Subject: Re: Aspirin vs. Codine
Message-ID: <435@spdcc.UUCP>
Date: Sat, 18-Oct-86 17:21:43 EDT
Article-I.D.: spdcc.435
Posted: Sat Oct 18 17:21:43 1986
Date-Received: Sun, 19-Oct-86 02:00:06 EDT
References: <1823@bu-cs.bu-cs.BU.EDU> <529@cci632.UUCP> <21708@rochester.ARPA> <372@uwmacc.UUCP>
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Organization: S.P. Dyer Computer Consulting, Cambridge MA
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Summary: inadequate analgesia

All well and good, Jess, but there *is* a record of doctors underprescribing
opiate analgesics when they would be most effective for pain, because of an
inappropriate fear of addiction.  This is true not only for terminal cancer
patients (where the whole idea of addiction as something to be avoided is
meaningless if not outright malicious), but also for acute pain in
postoperative and ambulatory patients.  The fact is that physical
addiction and psychological habituation practically never occurs when 
opiates are used for short periods of time for acute pain, especially
with a drug like codeine which is rarely a primary drug of abuse.  
This is not to say that aspirin or other non-narcotic analgesics aren't
the drug of first choice for many conditions, but giving a 200 lb. man
15 mg. of codeine 4 times a day after having his wisdom teeth out is
just plain stupid; the dose is much too low.

Chronic pain, such as lower back pain, or chronic conditions, such as
migraine, are a different matter and the risk of habituation needs to
be weighed against the patient's ability to receive relief from other
conventional therapies.
-- 
Steve Dyer
dyer@harvard.HARVARD.EDU
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