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Keywords:

  • Chronic Pain;
  • Medical Malpractice Allegations;
  • Iatrogenic Addiction;
  • Intractable Pain;
  • Opioids;
  • Chronic Opioid Analgesic Therapy;
  • Addiction;
  • Re-addiction;
  • Standards of Medical Care;
  • Breaches of Standards;
  • Aberrant Drug-Related Behaviors

Abstract

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.