Sickle cell disease -- when opioids and physicians fail.
An interview with a 32-year-old male with sickle cell anemia and multiple sequential admissions for vaso-occlusive crises, receiving high dose narcotic analgesics, is presented. The subsequent clinical discussion outlines psychiatric, psychosocial and treatment issues. Management of acute vaso-occlusive crisis is summarized along with a discussion of the value of comprehensive care for sickle cell disease patients. This article will be useful to physicians and consultation-liaison psychiatrists treating patients with sickle cell disease as well as policy makers developing service delivery models for this population.
Malach
Stephen
S
Hillside Hospital, Long Island Jewish Medical Center, Department of Psychiatry, Glen Oaks, NY, USA. smalach@yahoo.com
Levin
Tomer
T
Saravay
Stephen
S
Martin
Robert
R
Rao
Sandyha
S
Horowitz
Deborah
D
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000534:rehabilitation; D004351:Drug Resistance; D006760:Hospitalization; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*
D000701:Analgesics, Opioid