Opi­oid rules aren’t hard and fast

The Denver Post - - OPINION - Re: John C. Scott, M.D.,

“Pa­tients say they are hurt by rules,” Dec. 7 news story.

Your ar­ti­cle on opi­oids was ex­cel­lent. As a re­tired in­ternist and ge­ri­a­tri­cian, I would like to add three com­ments. 1. Geri­atric pa­tients are of­ten so com­plex that no sin­gle guide­line ap­plies to them. Many are in chronic pain. 2: Guide­lines are guide­lines, not rules. Doc­tors who ad­here strictly to them are tak­ing care of their rep­u­ta­tions, not their pa­tients, as their oath re­quires. 3: One of the un­in­tended con­se­quences of these guide­lines is the cur­rent heroin epi­demic among young peo­ple. Heroin is cheaper, eas­ier to get and has no dose guide­lines.

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