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- Page navigation anchor for Opioid use in family praciceOpioid use in family praciceShow More
I have sympathy to the concerns of opioid abuse and risk. The Canadian and especially the Pharmacare system in Manitoba does not create options for prescription freedom so that less harming substances could effectively be prescribed. We do not have the tools available to address the issues of concern addressed in this article. A big part of the problem is the system.
Dan Gerber
Conflict of Interest...
Competing Interests: None declared. - Page navigation anchor for You can't measure pain.You can't measure pain.Show More
Dear Editor,
I am fascinated by the wide range of sincere opinions when it comes to the question of treating chronic non-cancer pain with opioids. But in all the discussion one little fact is consistently overlooked, a fact that was stated most clearly by Eldon Tunks thirty years ago: you can't measure pain. It was true then, and it is equally true now. Which might have something to do with the absence of any so...
Competing Interests: None declared. - Page navigation anchor for The opioid crisis in North AmericaThe opioid crisis in North AmericaShow More
The study by Dhalla et al contributes to our understanding of the impact and causes of the opioid crisis in North America. Numerous studies have documented a dramatic increase in opioid-related harms, including rising rates of opioid addiction, overdose, emergency department visits and hospitalizations. These harms closely parallel the unprecedented increase in prescribing of controlled release opioids. These harms are...
Competing Interests: None declared. - Page navigation anchor for Clustering of opioid prescribing - what is really going on?Clustering of opioid prescribing - what is really going on?Show More
Dear Editors,
The statement that “the findings in this study suggest that family physicians might be able to reduce opioid related harm by writing fewer prescriptions” is unfounded by the data within the study. Further, in the absence of information regarding the appropriateness of the prescriptions written, such action might harm patients.
The authors have failed to consider alternate explanations for...
Competing Interests: None declared. - Page navigation anchor for Web Exclusive PublicationWeb Exclusive PublicationShow More
The Editors thank Dr. Pakes for his letter and comments.
Electronic publication of an article in Canadian Family Physician does not reflect any lesser status of the published work. All Web Exclusive publications in CFP are fully indexed and searchable in PubMed and PubMed Central.
There is limited print space in medical journals due to declines in pharmaceutical adverstising which has been a major sou...
Competing Interests: None declared. - Page navigation anchor for Treating Patients vs NumbersTreating Patients vs NumbersShow More
As a group of Canadian physicians interested in the management of patients with chronic pain and addiction, we feel compelled to respond to the recent paper by Dhalla et al regarding opioid-related deaths in Ontario: Clustering of opioid prescribing and opioid-related mortality among family physicians in Ontario. Dhalla et al. Can Fam Phys 2011:57:e92 -96.
Similar to a previous paper by some of the same authors...
Competing Interests: None declared. - Page navigation anchor for Opiod PrescribingOpiod PrescribingShow More
I was deeply disappointed that the editors of CFP felt that the Dhalla et al paper on opiod prescribing should be relegated to e-pub only status. From an ethical perspective, this is one of the most important issues for family physicians in Ontario. In medicine we often fail in our duty to help our patients as much as we ideally should, sometimes we even make honest mistakes that result in adverse patient outcomes. Opoid...
Competing Interests: None declared. - Page navigation anchor for MIND THE GAPMIND THE GAPShow More
Re” Clustering of opioid prescribing and opioid-related mortality among family physicians in Ontario” I.A. Dhalla et al. Can Fam Phys 2011:57:e92-96.
“MIND THE GAP”
“Do not put your faith in what statistics say until you have carefully considered what they do not say. ~William W. Watt”
The article by Dhalla et al. on opioid prescribing and opioid-related mortality reminds me of the phrase use...
Competing Interests: None declared. - Page navigation anchor for Clustering of opioid prescribing and opioid-related mortality... misleading conclusionsClustering of opioid prescribing and opioid-related mortality... misleading conclusionsShow More
Re: Dhalla et al. Clustering of opioid prescribing and opioid-related mortality among family physicians in Ontario
The dramatic rise of opioid-related deaths, emergency visits and adverse events in the United States and Canada is of significant concern to health care regulators, family physicians and patients. Unfortunately this study provides little insight into causal relationships associated with the increas...
Competing Interests: None declared. - Page navigation anchor for Disappointing studyDisappointing studyShow More
The flaw in the study is in it's arbitrary assessment of the qualitative risks involved. It gives unreasonable weight to the proposition that a single doctor can cause addiction to opiates (that those who become addicted would not have become addicted through another avenue) and also mistakenly accepts the current political persecution of opiate-dependent people - which is by and large responsible for most addiction rel...
Competing Interests: None declared.