Daniel Clauw, MD is a Professor of Medicine, Anesthesia, and Psychiatry at the University of Michigan and Director of the Chronic Pain and Fatigue Research Center. In this era of increasing opioid abuse and overdoses, and harsh criticism for doc's use of opioids in the setting of chronic pain, he provided his (not at all subtle) opinion in a Doc to Doc conversation with me.
Despite treating patients with a range of chronic pain issues, from fibromyalgia to interstitial cystitis, to low back pain, Dr. Clauw states "I haven't prescribed an opioid for chronic pain in at least a decade". With that phrase, Dr. Clauw has thrown down the gauntlet to other docs who feel that opioids are an acceptable, if lamentable, option for chronic pain treatment. Indeed, Dr. Clauw feels that doctors jump to quickly to opioids when patients might be better managed with tricyclics, gabapentinoids or even complementary and alternative therapies.
Are docs responsible for the opioid epidemic? Dr. Clauw states we have certainly played a role. He calls out surgeons and dentists who prescribe 30 days (or more) of opioids routinely postoperatively. "Surgeons...give these large prescriptions of opioids because they don't want to be called back for pain... I get that that makes your job easier."
Whether you find his viewpoint insightful or woefully unrealistic, his advice may very well stick with you.