Open AccessNonconsensual Dose Reduction Mandates are Not Justified Clinically or Ethically: An Analysis
Author(s) -
Stefan G. Kertesz,
Ajay Manhapra,
Adam J. Gordon
Publication year - 2020
Publication title -
the journal of law, medicine and ethics/the journal of law, medicine and ethics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 57
eISSN - 1748-720X
pISSN - 1073-1105
DOI - 10.1177/1073110520935337
Subject(s) - mandate , guideline , incentive , addiction , medicine , opioid , harm reduction , reduction (mathematics) , addiction treatment , actuarial science , intensive care medicine , business , psychiatry , political science , public health , nursing , economics , law , receptor , geometry , mathematics , pathology , microeconomics
This manuscript describes the institutional and clinical considerations that apply to the question of whether to mandate opioid dose reduction in patients who have received opioids long-term. It describes how a calamitous rise in addiction and overdose involving opioids has both led to a clinical recalibration by healthcare providers, and to strong incentives favoring forcible opioid reduction by policy making agencies. Neither the 2016 Guideline issued by the Centers for Disease Control and Prevention nor clinical evidence can justify or promote such policies as safe or effective.