The end of drug seekers?

[wonderdog]

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From the New England Journal of Medicine,

An fMRI-Based Neurologic Signature of Physical Pain

Basically they are using an fMRI as an objective way to measure pain. In your opinion, will this ruin things for drug seekers?

 

[NickNaylor]

From the New England Journal of Medicine,

An fMRI-Based Neurologic Signature of Physical Pain

Basically they are using an fMRI as an objective way to measure pain. In your opinion, will this ruin things for drug seekers?

No, because physicians are highly unlikely to send someone to get a MRI for the purposes of confirming pain. Cool finding in theory, but highly unpractical in the real world given the costs. What's the benefit? Why would I waste my time and hospital resources to get this done when a potential drug-seeker could simply go to another hospital or try their luck again with a clinician who doesn't want to send them off to get a MRI?

Again, cool finding in theory, but I just don't see it getting much use. Too much cost for very little benefit.

 

[thesauce]

From the New England Journal of Medicine,

An fMRI-Based Neurologic Signature of Physical Pain

Basically they are using an fMRI as an objective way to measure pain. In your opinion, will this ruin things for drug seekers?

No. For many reasons.

1. Insurance will not be on board because it's cheaper to fill a script for Oxys than to pay for an fMRI

2. You must be compliant in order to accurately undergo fMRI. Many drug seekers simply aren't going to agree to do it.

3. Many, if not most, hospitals don't have the resources/expertise to do fMRI

 

[chemsmith]

No, because physicians are highly unlikely to send someone to get a MRI for the purposes of confirming pain. Cool finding in theory, but highly unpractical in the real world given the costs. What's the benefit? Why would I waste my time and hospital resources to get this done when a potential drug-seeker could simply go to another hospital or try their luck again with a clinician who doesn't want to send them off to get a MRI?

Again, cool finding in theory, but I just don't see it getting much use. Too much cost for very little benefit.

Wherever there is a benefit people will work very hard to bring costs down. Japanese electronic giants have been building scaled-down MRIs for years at a fraction of the cost of the ones we use in the US. I can see it becoming practical in a short time.

 

[Microglia]

No, because physicians are highly unlikely to send someone to get a MRI for the purposes of confirming pain. Cool finding in theory, but highly unpractical in the real world given the costs. What's the benefit? Why would I waste my time and hospital resources to get this done when a potential drug-seeker could simply go to another hospital or try their luck again with a clinician who doesn't want to send them off to get a MRI?

Again, cool finding in theory, but I just don't see it getting much use. Too much cost for very little benefit.

This exactly. Until the cost comes wayyyyyyyy down I don't think this will have any effect on pain med seekers.

 

[mimelim]

Wherever there is a benefit people will work very hard to bring costs down. Japanese electronic giants have been building scaled-down MRIs for years at a fraction of the cost of the ones we use in the US. I can see it becoming practical in a short time.

Benefit is a nebulous term. At best it is marginal. There are a ton of beneficial applications for MRIs that have been known about for years that are not commonly used simply because the benefit doesn't outweigh the cost. It isn't just about the technology. You have to pay people to do the test, then pay someone to read the fMRI which at even large institutions is rarely more than one or two.

 

[calvnandhobbs68]

lol yeah lets run an fMRI on everyone who we think might be a drug seeker. You do realize that would cost more than just giving them drugs for the next five years right?

 

[Morzh]

Not to mention how notoriously controversial the reliability and interpretation of cortical fMRI imaging is. Let's see if this finding can even be consistently replicated, first. There are tons of "cool" fMRI "findings" every year (lie detectors, mind reading, etc.), but after the initial sensationalism is over it is often shown that, even though the results were accurately reported, the authors' (and medias') interpretations were unjustified extrapolations and speculation. This technology is still in relative infancy; let's not get ahead of ourselves.

For fun, though, let's entertain a hypothetical scenario:

Pt: "Doc, my back is killing me. I've been to 4 different specialists and nobody has been able to help."
(Doc sends pt for experimental fMRI study--comes back negative)
Doc: "Our scanner says that you aren't actually experiencing pain..."
Pt: "I don't care what your ********** scanner says, I'm in pain."

What if the patient is telling the truth?
What if the pt was your mom?
Are you gonna send 'em away just because the fMRI said so?

Is anybody really claiming that this imaging study is going to have a negative predictive value of 100%?