Addictive Disorders and Pain
People consume opioids for many reasons, some medically beneficial and others harmful to themselves and to society. It is difficult to conclude that opioid use is harmful by evaluating consumption alone. Consider a population of individuals none of whom have been exposed to opioid use. Within that population are those who do not have addictive disease involving opioids; these individuals will not demonstrate signs and symptoms of addiction whether exposed to opioids or not. A smaller group within the population has addictive disease. Some in this group do not know they have addictive disease simply because they have never been exposed to opioids. Phenotypically, then, they do not have addiction despite the underlying physiology. Another group of individuals, however, will show signs of addiction, resulting from medical or nonmedical use of opioids.
KeywordsChronic Pain Ventral Tegmental Area Opioid Therapy Addictive Disorder Alcoholic Anonymous
Technical writing and manuscript review are provided by Beth Dove of Medical Communications, Salt Lake City, Utah.
- 6.Hennecke L. Stimulus augmenting and field dependence in children of alcoholic fathers. J Stud Alcohol Drugs. 1984;45(6):486–92.Google Scholar
- 7.Public policy statement on the rights and responsibilities of healthcare professionals in the use of opioids for the treatment of pain: a consensus document from the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine. Adopted 2004. Available at http://www.ampainsoc.org/advocacy/pdf/rights.pdf. Accessed 7 Jan 2010.
- 9.Federation of State Medical Boards of the United States, Inc. Model policy for the use of controlled substances for the treatment of pain. 2004. Available at: http://www.fsmb.org/pdf/2004_grpol_Controlled_Substances.pdf. Accessed 7 Jan 2010.
- 10.Webster LR, Dove B. Avoiding opioid abuse while managing pain: a guide for practitioners. 1st ed. North Branch: Sunrise River Press; 2007. p. 145.Google Scholar
- 11.National Institutes of Health, U.S. Department of Health and Human Services. Drugs, brains, and behavior: the science of addiction. NIH Pub No. 07–5605. Printed Apr 2007.Google Scholar
- 12.National Institutes of Health, U.S. Department of Health and Human Services. Research report series. Comorbidity: addiction and other mental illnesses. NIH Pub No. 08–5771. Printed Dec 2008.Google Scholar
- 21.Coambs RB, Jarry JL. The SISAP; a new screening instrument for identifying potential opioid abusers in the management of chronic nonmalignant pain in general medical practice. Pain Res Manag. 1996;1(3):155–62.Google Scholar
- 29.Katz N. Patient level opioid risk management: a supplement to the PainEDU.org manual. Newton: Inflexxion, Inc; 2007.Google Scholar