In this illuminating episode of Hope Illuminated, I sit down with Dr. Stefan Kertesz, a seasoned researcher from the University of Alabama, Birmingham, to unravel the complexities surrounding pain, opioids, addiction, and suicide.
Stefan shares his profound insights into the intricate relationship between these factors, drawing from his extensive experience in caring for vulnerable populations. We delve into the repercussions of removing individuals from opioid medications while they grapple with unmanageable, intractable pain, shedding light on the multifaceted challenges faced by both patients and healthcare professionals.
From personal anecdotes to evidence-based research, Stefan navigates the nuances of this pressing issue with compassion and expertise. His dedication to understanding the deep-rooted stories behind statistical data underscores the importance of listening to individual experiences in shaping effective healthcare policies and interventions.
Join us on this enlightening journey as we explore the intersections of pain, addiction, and suicide, seeking pathways to support and hope for those navigating these complex dynamics.
More about Stefan Kertesz
Dr. Kertesz is a Professor at the University of Alabama at Birmingham Heersink School of Medicine and the affiliated Veterans Affairs Medical Center. Dr. Kertesz also leads an ongoing federally funded interview study that seeks to interview survivors in order to learn about suicides that have taken place after a reduction or stoppage of pain medication (more at https://go.uab.edu/csiopioids).
Board-certified in both internal medicine and addiction medicine, Dr. Kertesz has carried out research on how to improve health care delivery for populations affected by homelessness, addiction and pain over the last 22 years.
(if you would like a link to my faculty profile: https://scholars.uab.edu/457-stefan-kertesz )
Takeaways
Understand the complexities of pain, opioids, addiction, and suicide interplay.
Advocate for compassionate, individualized care to prevent tragic outcomes.
Contact Stefan
X: @StefanKertesz
Show Notes
For persons who would like to consider participation, our basic information and preliminary screener are here: https://go.uab.edu/csi
More detailed information about the CSI:OPIOIDs study and team is here: www.csiopioids.org
On Becoming a Healer podcast episode on opioids and suicides: https://pod.link/healer/episode/f233b79372506ae4c0a1c11b1539b614
Danny Elliott's story of his injury and his death was produced as a podcast on Vice.com in
January, 2023: https://shows.acast.com/vice-news-reports/episodes/the-end-of-pain
Danny Elliott's story was reported as an article by Vice.com a few months earlier: https://www.vice.com/en/article/wxnyb9/dea-fentanyl-doctor-patient-suicide
Our study inspiration is from Ms. Anne Fuqua, who is a person with long-term pain. Her story features in the New York Times: https://www.vice.com/en/article/wxnyb9/dea-fentanyl-doctor-patient-suicide
Cassonya Slone's story of a successful lawsuit was reported in depth by STATNews: https://www.statnews.com/2021/11/22/her-husband-died-by-suicide-she-sued-his-pain-doctors-a-rare-challenge-over-an-opioid-dose-reduction/
The CDC's new and very temperate guidance of 2022 was heavily influenced by elaborate and careful consultation with patients and families, and it is summarized here: https://www.cdc.gov/opioids/patients/guideline.html
Our Veterans Administration report of an association between stopping prescriptions and suicide was published in a major medical journal. Please note: I caution that these large retrospective database exercises don't prove a simple cause and effect. Nothing is simple in this domain https://www.bmj.com/content/368/bmj.m283
As a scientific and ethical overview, one of my co-investigators and I summarized all studies available through 2022, and we argued for informed consent when considering reduction of prescribed opioids in long-term recipients, in most instances, with very careful exceptions. We make this case in JAMA Network Open in a piece titled "New Data on Opioid Dose Reduction--Implications for Patient Safety" https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2793299
My doctor says they have to lower my long-term opioid medicine. “What can I do? What do I say?”https://stefankertesz.medium.com/my-doctor-says-they-have-to-lower-the-long-term-opioid-what-can-i-do-what-do-i-say-b3d35776379e