Medical Journal Houston Vol. 11, Issue 1, April 2014

Legal Affairs: Halifax Hospital Settlement: Scrutiny of relationships between hospitals and physicians, see page 4

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The Leading Source for Healthcare Business News
April 2014 • Volume 11, Issue 1 • $3.50

Special Feature: Addiction

Good intentions; unintended consequences
INSIDE
▼
NeuroPace® RNS® System
for epilepsy treatment
see page 10

INDEX
▼
Financial Perspectives.......3
Legal Affairs......................4
THA.................................6
Breaking Ground..............8
Integrative Medicine.........9
Technology......................10
Physicians Forum............11

by W. Clay Brown,
M.D., Medical Director
of Adolescent Services,
Memorial Hermann
Prevention and Recovery
Center, and Mike Leath,
R.Ph., M.D., Chief
Physician, Memorial
Hermann Prevention and
Recovery Center
In our culture of immediate
gratification and quick fixes,
the role a medical doctor
unwittingly plays in substance
abuse or addiction relapse sometimes boils
down to simply prescribing a standard
medication to resolve a temporary medical
issue: Ambien for difficulty sleeping, Soma
for a sprained back muscle, or Vicodin for a
root canal.
However, a short-term solution may
inadvertently lead a patient into a lingering
struggle with addiction or a slide back into
substance abuse.
Today, there are  approximately 750,000
physicians in active patient care in the
United States. Unfortunately, a significant
number have had less than half a day of

training in prescription drug diversion.
Thus, many doctors may be  unaware
of mood/mind-altering properties of
certain medications, especially with new

medications coming onto  the market, or
uninformed about the problem of crossaddiction, the swapping one substance for
another.
Please see ADDICTION page 15

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The Opioid Dilemma: A Catch-22 in Medical Practice?
Digital dementia and
internet addiction
see page 9

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J. Lance LaFleur, MD,
MBA, Houston Pain
Centers
“If we know that severe pain
and suffering can be alleviated

and we do nothing about it, we, ourselves,
are tormentors.” –Primo Levi
It is difficult to overestimate the stakes of
the accurate management of pain. Left
undiagnosed and untreated, the headache
after subarachnoid hemorrhage or the
arm pain from myocardial infarction or
chondrosarcoma could very well be lethal.
When the pain is not only a symptom, but
a disease state, the diagnostic and treatment
quandaries remain. Unfortunately, the use
of opioids, one of the historic mainstays
of therapy for the chronic pain patient, is
becoming increasingly complex.
Approximately 8% of Americans with
immense suffering, who are often confined
to their homes because of severe, disabling

pain, comprise part of the total 37% in our
nation with chronic pain.1 The cost of
medical treatment for patients with chronic
pain in the U.S. is in excess of $100 billion
annually.2
Current treatment paradigms employed
by fellowship trained, board-certified
interventional pain physicians are both
comprehensive and multidisciplinary. They
often include rehabilitation approaches
(e.g., assistive devices and physical or
aquatic therapy), lifestyle changes, adjuvant
analgesics and opioids, psychological and
psychiatric approaches (e.g., cognitive
behavioral therapy and transcranial
magnetic stimulation), spine and joint
injections, and radiofrequency ablation of
nerves. Some patients with severe, refractory
Please see CATCH-22 page 16

PRSRT STD
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HOUSTON TX
PERMIT NO 13187