Summary Three medico-legal forensic case reports where pain medicine defendants were accused of causing iatrogenic opioid addiction and re-addiction during chronic opioid analgesic therapy are detailed. Issues such as informed consent are discussed in reference to these allegations.
Medical Malpractice Allegations of Iatrogenic Addiction in Chronic Opioid Analgesic Therapy: Forensic Case Reports
Article first published online: 30 AUG 2010
Wiley Periodicals, Inc.
Volume 11, Issue 10, pages 1537–1545, October 2010
How to Cite
Fishbain, D. A., Lewis, J. E. and Gao, J. (2010), Medical Malpractice Allegations of Iatrogenic Addiction in Chronic Opioid Analgesic Therapy: Forensic Case Reports. Pain Medicine, 11: 1537–1545. doi: 10.1111/j.1526-4637.2010.00938.x
- Issue published online: 28 SEP 2010
- Article first published online: 30 AUG 2010
- Chronic Pain;
- Medical Malpractice Allegations;
- Iatrogenic Addiction;
- Intractable Pain;
- Chronic Opioid Analgesic Therapy;
- Standards of Medical Care;
- Breaches of Standards;
- Aberrant Drug-Related Behaviors
Objectives. The objectives for presenting these medico-legal forensic case reports are the following: 1) detail three cases where chronic opioid analgesic therapy (COAT) was alleged to cause iatrogenic addiction and/or re-addiction; 2) detail the plaintiff's and defendant's medical experts' opinions on these allegations; and 3) through analyzing these cases, develop some recommendations for future prevention of such allegations during COAT.
Methods. Case Reports.
Results. Medico-legal issues surrounding the allegation of iatrogenic addiction were identified in each case.
Conclusions. Before starting COAT, physicians should obtain and document patient informed consent for the risk of addiction/re-addiction with COAT treatment. Patients with a history of addictions pre-COAT should be placed on adherence monitoring immediately on beginning COAT.