Opioid Therapy Controversy ...

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Posted by Dave Emond ( on October 15, 2001 at 13:09:46:

Hi Gang,
I have contacted the head doctor, Dr, William Hurwitz, about his views on CH and Opioid medications.
I did this out of interest after recieving e-mails from aka WaterDog. I went back through the archives and read every post between Waterdog and others, trying to figure out just what caused this to become such a controversy and eventually a flamming session between WaterDog and many others. I have no judgement against either sides views, and didn't see evidence that either side was "right or wrong". So, I thought I'd go back to the original issue, and contact the "expert" in the field. I contacted Dr. Hurwitz asking for specific studies and cases of Opioid therapy in relationship to Cluster Headaches. I told him I would share his response with you. (So I am not posting a private e-mail.)His response:
"Dear Mr. Emond,
I have no current patient named Micheal Roark (aka Waterdog), and I don't recall ever treating someone with that name. I have spoken with a large number of people whose names I do not recall. Perhaps I spoke with Mr. Roark at some point.
I had a number of patients with cluster headaches, some of whom obtain relief when adequate doses of opioid medications are given. I think they are worth trying if other approaches have been ineffective.
Nothing in medicine is perfect, and some patients don't respond. Opioid medications provoke headaches in some patients.
I hope this information has been useful.
Best Wishes,
William Hurwitz, MD"

Okay, from this very short response, I've come to my own conclusions (doesn't make them right).
There is no reason to think that Mr. Roark hasn't found his pain relief from "Dr. Bill's" therapy. And obviously had no self serving reason for his original posts on the matter. As I followed the path of the postings WaterDog was at first accepted and thanked for his input. Then a few disagreements were posted, then prides took over and it lead to posts that wasted everyone's time. Still, I remain neutral, as I'm more interested and thought you might be to the facts behind this therapy.
Having asked Dr. Bill for specifics; case studies, analysis, etc., I was a bit discouraged at such a simple response. I was surprised he left out "vascular" before "headaches" as is stated as a side effect of this therapy with many others (Also left out)on his web site.
I expected an exhaustive report on the relationship between CH and Opioid Therapy, but instead got what I feel is an inadquate response. I do suspect that studies have NOT been done to support this alternative treatment. From reading Dr. Bill's web site, this can be a very dangerous treatment. (www.drhurwitz.com)
I do tend to believe WaterDog originally only sought to pass on pain management alternatives, but the communications broke down, and the future postings from all sides then led nowhere. I don't think WaterDog suffers from CH (at least I haven't heard it from him yet).
Conclusion: I personally would not take this route. Even though no prevenative drugs work for me, the risks appear to be too dangerous. However, I would understand another using it as a last resort, and I emphasize LAST resort.
I'm posting this in hopes that we can do away with one less "feud" on the message board. And in hope that newcomers are not going to see these feuds on the boards and leave. I'm against censorship on the board, but hope we can all take the responsibility to censor ourselves a bit for the sake of newcomers.
(I understand many have grievences with WaterDog, this is not about him, but about the treatment, so I please ask this not become a conversation about an individual, but about an alternative treatment for pain.)
The response by Dr. Bill is here, and so is his website, each can determine for themselves whether or not it is viable to their own selves.
"Just the facts Ma'am." : )

(To the one who wrote me and said Waterdog's computer would be down for a few weeks, please inform him of this post, thanks.)

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