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.
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MAP posted-by: Jay Bergstrom