Acknowledging Heroin Dependence as a Preventable Pediatric Chronic Medical Condition

Drug dependence as a chronic medical illness.

To the Editor: Dr McLellan and colleagues state that drug addiction should be treated as a chronic medical disease. This contradicts our experiences as a sheriff (L.A.) and an emergency department physician (D.L.S.) who regularly encounter patients who provide false histories concerning trauma or pain syndromes, insist on narcotic analgesics, and vigorously refuse nonnarcotic analgesics or foll...

Chronic Heroin Dependence Leading to Adrenal Insufficiency

Opioids have been the mainstay for pain relief and palliation over a long period of time. They are commonly abused by drug addicts and such dependence usually imparts severe physiologic effects on multiple organ systems. The negative impact of opioids on the endocrine system is poorly understood and often underestimated. We describe a patient who developed severe suppression of the hypothalamic...

Medical Malpractice: A Preventable or Inevitable Issue

Drug Dependence, a Chronic Medical Illness

Author Affiliations: The Treatment Research Insti­tute, Philadelphia, Pa (DrMcLellan); The Penn/VA cen­ter for Studies of Addiction at the Veterans Affairs Medical Center and the University of Pennsylvania, Philadelphia (Drs McLellan and O'Brien); The Brown University Center for Alcohol and Addiction Studies, Providence, RI (Dr Lewis); and The National Center on Addiction and Substance Abuse at...

Harm-Reduction as Risk Decreasing Strategy in Heroin Dependence

1 Manuscript received August 31, 2010. Daniel Vasile is Associate Professor of Clinical Psychopharmacology, Chief Clinic of Psychiatry, University Emergency Central Military Hospital “Dr. Carol Davila”. Contact address: Bucharest 88, M. Vulcanescu Str., 010825, Bucharest, Romania, e-mail : [email protected]. The presenting author is speaker for: Astra Zeneca, Bristol Myers Squibb, CSC Pharma...