Medico-legal rounds: Medico-legal issues and breaches of "standards of medical care" in opioid tapering for alleged opioid addiction.
OBJECTIVE
The objectives of this medico-legal case report are the following: 1) To present an example of a medico-legal problem that developed as a result of reports of alleged opioid addiction that resulted in a decision to taper a chronic pain patient (CPP) from opioids; 2) To present both the plaintiff's and defendant's expert witness opinions as to if and how the care of that patient fell below the "standard of medical care"; and 3) Based on these opinions, to develop some recommendations on how, in the future, pain medicine physicians and other physicians should proceed in similar circumstances in order to avoid allegations of breach of "standard of medical care."


METHODS
Case Report.


METHODS
Regional Hospital Pain Clinic.


METHODS
CPP Interventions. Opioid tapering because of aberrant drug-related behaviors (addictive behaviors).


RESULTS
During the tapering process, the CPP committed suicide. This had medico-legal consequences. Expert witnesses could not rule out the possibility of pseudoaddiction in this CPP.


CONCLUSIONS
Further research into the concept of pseudoaddiction is required.
Fishbain
David A
DA
Departments of Psychiatry, Neurological Surgery, and Anesthesiology, University of Miami School of Medicine, and University of Miami Comprehensive Pain and Rehabilitation Center, Miami, Florida 33139, USA. d.fishbain@Miami.Edu