Dr C. Patrick Carroll on Caution Using Opioids to Treat Sickle Cell Disease–Related Pain

Patients had never been particularly enthusiastic about using opioids to treat their pain related to sickle cell disease, but they are more cautious now, especially as they are often meet with suspicion of addiction, said C. Patrick Carroll, MD, director of psychiatric services, Sickle Cell Center for Adults, associate professor of psychiatry, Johns Hopkins Medicine.

Transcript

Given the opioid epidemic, are patients who experience pain related to sickle cell disease more cautious about being prescribed and using opioids?

Well, I think first off, people were, in my experience, we're not terribly enthusiastic about taking opioids or being on opioids in the first place. So, I don't think very many people were, I don't think people were really sanguine about it before the opioid epidemic. So, in that way, things haven't changed all that much.

I think people are, patients probably are a bit more cautious. I think providers are more cautious. But there's also been, I think, a bit of an exacerbation of a standing problem, which is that people with sickle cell disease are very, are met with a great deal of suspicion of addiction. It's a condition where you can have very severe acute pain that has no objective signs, and it's treated with opioids. And so, it's kind of a setup for that. And I think that has gotten a bit worse in the past few years.