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Opioid Treatment: Considering the Patients Environment

Dr Travis Rieder of Johns Hopkins University discusses the importance of considering a patient's environment when treating them for opioid use disorder (OUD).

Transcript

[music]

In 2015, I was in a motorcycle accident and I spent a couple of months going through reconstruction surgeries and on heavy doses of opioids.

And in the wake of that experience, I felt like I'd learned a lot from the perspective of a patient, and it changed everything.

I was given a terrible tapering schedule and went into catastrophic withdrawal and the reason I made it out of 29 days in withdrawal is because I had an incredibly supportive partner and I wanted-- and I had a one-and-a-half-year-old daughter that I desperately wanted to parent again.

And that had nothing to do with pharmacology, like that the biology was doing its thing and whether or not I went back on the medications was entirely determined by my environment.

And so, if we don't look at our patients and think about their environment and their family and their structures and their support systems, we're missing a big part of the risks and the benefits and how we weigh certain therapy options for them.

I think that if we imagine that the only risks that come from say opioids or any drugs that can cause dependence or addiction...

If we think the only risks are kind of pharmacological, we're gonna miss a big part of the picture, right, because pain is complex and philosophically weird and pain medication is complex and really hard and it changes over the long-term.

And we're only now learning things about say opioids that we've been using for a hundred fifty years.

[silence]

This page was last updated October 2019