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What to Look for in this
Issue of the Bulletin
This issue of the Bulletin is devoted
in large part to stories related to the
“opioid crisis.” In it, you will find a
compendium of information about opioid
prescribing guidelines and the recently
passed legislation, which was derived
from those guidelines (and some might
say, misinterprets them, since they were
never intended to serve as the basis for
law-making.) See “MI New Opioid Law and
its Impact” for a reminder of what is in the
current law, and “What are some of the
Existing Guidelines?” to find out what they
are and where they originated. In this issue
you will also find stories that I hope will shed light on how we got to where we are today (see “The Opioid Crisis:
A History.”) Learn about the legislative history of the
current legislation and read about the recent visit from the U. S. Surgeon General, whose contributions to the opioid discussion were lacking.
There is little doubt that opioid medications have been overprescribed since pain was declared the “fifth vital sign” over two decades ago. Shedding light on this issue and bringing needed change to post-operative prescribing practices should be salutary, but leaves unaddressed how to deal with the majority of opioid prescribing, which is for patients with chronic, not acute, pain
and what some of the consequences, intended and unintended, particularly for primary care physicians might be. See in this issue: “Poor Prescribing or Poor Pain Management?”
State legislation regarding opioid prescribing is clearly a bandwagon phenomenon. See what other states have done and how that is quite similar to what Michigan has done in “Other State Responses.”
You will also find an insightful essay by Alon Weizer on why it bothers him to be called a “provider,” as well as the next chapter of the continuing story of what it was like to be a medical student in 1968, a tumultuous year that has also been in the news of late, and our usual features and updates.
By Richard E. Burney, MD
  4 Washtenaw County Medical Society BULLETIN APRIL / MAY / JUNE 2018

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