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The recent murder of Dr. Todd Graham has shaken physicians across the U.S.

Graham was shot by the husband of a new patient who had asked him earlier that day for opioids to control chronic pain. Graham, an orthopedist in Mishawaka, Ind., had refused to write the prescription, explaining that the powerful pain pills weren’t appropriate treatment. The patient’s husband tracked him down later in the parking lot and pulled out a gun.

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Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, has been following the story with horror. STAT talked to him about the pressures that doctors face to prescribe opioids — and the risk that patients will turn violent if denied. Kolodny is also co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University. The interview has been edited lightly for clarity.

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  • This is going to be the first of many such stories, I’m afraid. Just like efforts to repeal ACA before a viable replacement exists are doomed to failure, enacting strict controls on physicians’ prescribing, limits on insurance drug coverage policies and various other disincentives to proper management of chronic pain will, in the absence of a plan and a source for patients to get relief predictably cause more vocal and violent reactions among patients. Or as in the Graham case, spouse or other family members. All clinics will need armed guards, just as EDs have for years. Parking lots will have to be secured and possibly doctors will need bodyguards. Just reading the responses from patients to the prior article tells me that there will be a rash of patient suicides. I believe that people who are re-promulgating the long discredited “war on drugs” will be responsible for a rash of deaths. Which they will then predictably blame on others.

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