Fw: JAMA article 23 August 1965. Dole/Nyswander. Sydney pain conference.
ptpeet at nyc.rr.com
Wed Aug 24 13:15:01 EDT 2005
Peace and love,
"Madness is not enlightenment, but the search for enlightenment is often
mistaken for madness"
ptpeet at nyc.rr.com
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----- Original Message -----
From: Andrew Byrne
To: 'Andrew Byrne'
Sent: Monday, August 22, 2005 11:35 PM
Subject: JAMA article 23 August 1965. Dole/Nyswander. Sydney pain
Apologies for repetition, but I think it is fair to shout loud and long
about this pivotal study describing the first 24 patients on formal
methadone treatment (with 22 'retentions'). The paper concentrates on
reducing or eliminating illicit drug use and getting people back to work,
studies and their families. There is no focus on 'detoxification' or being
'drug free' . but an average methadone dose of 100mg daily (range 15-180mg),
a warning about too rapid inductions and practical measures against
constipation, the only common side effect of treatment.
I spoke to Dr Vincent P. Dole this morning on the telephone and he sends his
best greetings and wishes to us in Sydney where we are hosting a large
international meeting on pain management with over 5000 delegates attending.
Dr Dole is recovering from a stroke but is remarkably acute, speaking
eloquently about the difficulties dependency patients face in managing
In a talk last evening by Dr Doug Gourlay of Toronto, we were presented with
a 'universal' and practical approach to the pain and dependency patient
utilising the modalities of both specialties to diagnose and manage their
pain and addiction problems (summary to follow). We were honoured to be
joined by two early members of Dole's Rockefeller team, Dr Joyce Lowinson
and Dr Herman Joseph who are both 'legendary' for their publications, texts,
talks and experience in the addiction field.
We owe a great deal to all these pioneers (copy of 1965 paper on request).
But as Dole once said in a keynote address, they were "but base-stations in
the assault on the mountain's summit" which others must face in the future.
With modern heroin trials, needle services, buprenorphine and 'NA', how
right he was, all those years ago!
Best wishes to all in this challenging but rewarding field.
Andrew Byrne ..
Dr Andrew Byrne MB BS (Syd) FAChAM (RACP)
75 Redfern Street, Redfern,
New South Wales, 2016, Australia
Email - ajbyrneATozemail.com.au
Tel (61 - 2) 9319 5524 Fax 9318 0631
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