From NPR podcast of Fresh Air with Terry Gross:
Rieder likens his experiences trying to get off prescription pain meds to a game of hot potato. “The patient is the potato,” he says. “Everybody had a reason to send me to somebody else.”
Eventually Rieder was able to wean himself off the drugs, but not before receiving bad advice and going through intense periods of withdrawal. He shares his insights as both a patient and a bioethicist in a new book, In Pain: A Bioethicist’s Personal Struggle With Opioids.
Press play button above to hear interview.

In 2015, Travis Rieder, a medical bioethicist with Johns Hopkins University’s Berman Institute of Bioethics, was involved in a motorcycle accident that crushed his left foot. In the months that followed, he underwent six different surgeries as doctors struggled first to save his foot and then to reconstruct it.
Rieder says that each surgery brought a new wave of pain, sometimes “searing and electrical,” other times “fiery and shocking.” Doctors tried to mitigate the pain by prescribing large doses of opioids, including morphine, fentanyl, Dilaudid, oxycodone and OxyContin. But when it came time to taper off the drugs, Rieder found it nearly impossible to get good advice from any of the clinicians who had treated him.
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The learning curve was steep: “I couldn’t read; I couldn’t write. I could see the hospital signs, the elevator signs, the therapists’ cards, but I couldn’t understand them,” he wrote. The aphasia — the inability to understand or express speech — “had beaten and battered” his pride.
“The doctor asked whether he was sure that he had not taken anything else when he was sick? No acetaminophen? No herbs or supplements? The man was certain. Moreover, his labs were abnormal even before he took the antibiotics. The doctor hypothesized that the man’s liver had been a little inflamed from some minor injury — maybe a virus or other exposure — and the antibiotic, which is cleared through the liver, somehow added insult to injury.”
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From time immemorial, an invariable feature of doctor–patient interaction has been that it takes place in person. But the status quo is changing. A large portion of patient care might eventually be delivered via telemedicine by virtualists, physicians who treat patients they may never meet.
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