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Hi! Banimahd! I'm fairly fresh but my first clinical job were at a university addiction in patient setting. I have the following questions:

1: One of the most frequent "medical dilemmas" brought up in medical ethics talks is what to do in the case of a drug addict (I know we say substance use disorder but it's not how other docs term it) or a former drug addict that is in the hospital for a somatic reason. A surgery or injury or something. Now the dilemma the treating doctor is facing is do I increase the opiats when the patient claims to be in pain or do I then risk to either support a ongoing addiction or spiral someone back into previus addiction. I would always advice to give the medication because my logic is that if the patient already is addicted the hospital morphine is way better than street drugs and if they are not the safest way to push them back into addiction is to leave them in pain so they go back to the streets for painkillers.

Now, do you agree with me or do you have another view? Is there relevant research for this predicament?

2: How do we find the balance where we can still use benzos to treat the patients that truly need it (not talking about treating withdrawls but other indications) but not risk making people addicted?

3: What are your thoughts on pregabalin? It seems its use is increasing and people sure hate tapering down.