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Opioid Administration for Severe Neuropathic Pain in a Patient With Depression and Prior Heroin Use

Elliott, Kathryn J. MD, JD, MSc

doi: 10.1212/01.CON.0000411563.41709.e3
Ethical Perspectives

The treatment of pain can raise ethical dilemmas. This article presents a case of a young woman with a pain crisis from severe neuropathic pain that is complicated by comorbidities of depression and prior (but not active) heroin use. Medical and ethical justifications for either withholding or providing opioids for her pain are examined. State and federal laws governing opioid prescriptions by physicians for pain management are reviewed.

Address correspondence to Dr Kathryn Elliott, Mount Sinai Medical Center, Annenberg Building, 1468 Madison Avenue, 2nd Floor, Room 218, New York, NY 10029, kathryn.elliott@mssm.edu.

Relationship Disclosure: Dr Elliott is the principal or co-investigator for clinical trials supported by CSL Behring, Eli Lilly and Company, NIH, and Pfizer Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Elliott reports no disclosure.

© 2012 American Academy of Neurology