Pubdate: Tue, 02 Mar 2004 Source: Medical Post (Canada) Copyright: 2004 The Medical Post Contact: http://www.medicalpost.com/ Details: http://www.mapinc.org/media/3180 Author: Dr. W. D. Panton, retired Referenced: http://www.mapinc.org/drugnews/v04/n229/a05.html?24929 A CASE OF BIAS OR DISINFORMATION? In the Feb. 3, 2004, edition of the Medical Post ("Your bias may be keeping pot from pain patients"), the matter of bias was raised by Dr. Romayne Gallagher, a professor at the University of British Columbia, who said, "A lot of chronic patients feel subconsciously bad about taking pain medication . . . reinforced by physician bias." A good example of such bias might be found in your Feb. 10 issue ("Narcotics still given to heavy drinkers for pain"), in which Dr. Andrew Haig, a professor of physical medicine and rehabilitation at the University of Michigan, claimed doctors who prescribe narcotics for patients who consume alcohol are not following their own rules, i.e. "prescribing fewer narcotics to heavy drinkers." He goes on to say narcotics combined with alcohol can cause liver damage. Would any such damage in fact not be more likely attributable to the effects of acetaminophen, taken in excess, as in when access to codeine or morphine has been restricted? While Dr. Gallagher seems to address her patients' needs for effective analgesics, Dr. Haig would appear to be more concerned about his patients' use of narcotics than about finding more effective measures for relieving their discomfort. Considering the popular concept of drug-related crime, or drug-related liver disease, might it not be, contrary to common opinion, more likely a case of drug prohibition leading to much of the damage, internal or otherwise? In situations such as these, one wonders whether the old word "bias" can sometimes sadly but accurately be replaced with the modern word "disinformation." Dr. W. D. Panton, Burnaby, B.C., retired. - --- MAP posted-by: Jay Bergstrom