Summary and Analysis
This article is an important summary of the "devastating" effects of equating the "practice of medicine" with the "prescribing of drugs."
In the area of drug addiction prevention and treatment, we are all too familiar with the problems generated by over-prescribing. The rush to place Medication-Assisted Treatment (MAT) at the center of the official response to the opioid crisis is but the latest in a long series of mistakes in which it was assumed more drugs would solve our health problems.
In contrast, the article defines "evidence-based medicine" to encompass many aspects of care, not just pharmacology: "...the integration of clinical expertise, the best available evidence and – most importantly – taking patients’ preferences and values into consideration."
"Many pathways to recovery" and "choice in treatment" are the analogs in the addiction treatment world of the last point -- patient preferences and values. Never has it been more important to defend and protect the concept of "many pathways to recovery" than in today's world of highly marketed MAT.
Excerpted from The Guardian
When former airline pilot Tony Royle came to see me last year to seek reassurance that it was OK to participate in an Ironman event, having stopped all his medications 18 months after suffering a heart attack, I was initially a little alarmed.
But after talking to him, I realised he had made an informed decision to stop the medication after suffering side effects, and instead had opted for a diet and lifestyle approach to manage his heart disease.
His case is a great example of how evidence-based medicine should be practised. This is the integration of clinical expertise, the best available evidence and – most importantly – taking patients’ preferences and values into consideration.