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Author Topic: Definition of "Drug seeking behaviour"  (Read 3327 times)

Offline Pmb

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Definition of "Drug seeking behaviour"
« on: 18/10/2013 03:18:46 »
I'm looking for the precise definition of the term drug seeking behaviour. Does anyone know what it is and the source of the defintion? I know a variety of definitions but I have a need for it as defined by a respectable source (and not a journal article which carries a personal opinion with it).

I looked in the DSM-4 and while it uses the term twice it doesn't define it.
« Last Edit: 18/10/2013 03:24:01 by Pete »


 

Offline RD

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Re: Definition of "Drug seeking behaviour"
« Reply #1 on: 18/10/2013 06:05:21 »
« Last Edit: 18/10/2013 06:07:19 by RD »
 

Offline CliffordK

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Re: Definition of "Drug seeking behaviour"
« Reply #2 on: 18/10/2013 08:19:47 »
The DSM-IV or DSM-5 are considered the standard for mental diagnoses.  It has been a while since I've looked at it, but I always thought it was a bit terse, and dry.  I'm not quite sure how a 1000 page book could be considered terse.  Perhaps I had a summary.

Wikipedia also has information on Substance dependence, Substance Abuse, and Substance Use Disorders

Anyway, drug seeking behavior seems to be inextricably intertwined with substance dependence.

When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped.
[...]
Drug addiction is characterized by strong, drug seeking behaviors in which the addict persistently craves and seeks out drugs, despite the knowledge of harmful consequences.

Reading through the Wikipedia articles, you might also be interested in:

There is also a lesser known situation called pseudo-addiction.  A patient will exhibit drug-seeking behavior reminiscent of psychological addiction, but they tend to have genuine pain or other symptoms that have been under-treated. Unlike true psychological addiction, these behaviors tend to stop when the pain is adequately treated.

Unfortunately many people with drug addiction problems became addicted from legitimate medical treatment, for example automobile accident victims.  And thus the line between pain and addictions becomes blurred.

As always, Wikipedia often has good references which are worth reviewing.
 

Offline Pmb

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Re: Definition of "Drug seeking behaviour"
« Reply #3 on: 18/10/2013 12:07:18 »
You may get some leads from ... https://en.wikipedia.org/wiki/Double_doctoring#References
Thanks. However, as I mentioned in the OP, I require a repudable source. That's because its what I need to bring into court with me and courts don't accept wikipedia. Also I've been told my the doctors that double doctoring is different than drug-seeking.

Cliff - I created this thread because it's not defined in the DSM. It's merely used without definition.
 

Offline Pmb

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Re: Definition of "Drug seeking behaviour"
« Reply #4 on: 18/10/2013 12:19:08 »
Quote from: CliffordK
Unfortunately many people with drug addiction problems became addicted from legitimate medical treatment, for example automobile accident victims.  And thus the line between pain and addictions becomes blurred.
In all the information that I've obtained by respectable sources states that people who use pain medication for pain don't become addicted. That's a rare thing, the excpetion, not the rule. The correct term is "few" rather than "many."

From the pamphlet Speak Up - What you should know about pain management from The Joint Commission http://www.jointcommission.org/assets/1/18/painmanagementbrochure.pdf
Quote
Are you afraid that you'll become addicted to pain medicine?

This is a common concern of patients. Studies show that addiction is unlikely. This is especially true if the patient has never had an addiction. Talk to your doctor or nurse about your fears.
« Last Edit: 18/10/2013 12:26:33 by Pete »
 

Offline CliffordK

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Re: Definition of "Drug seeking behaviour"
« Reply #5 on: 18/10/2013 13:28:30 »
You could argue that if the definition of "Drug seeking behavior" is not in either the DSM-IV, or DSM-5, then it is not a "medical diagnosis".  However, I would try to find an electronic version that you could do a keyword search on.

In fact, it sounds to me like quite a subjective opinion.  However, undoubtedly it is something nurses and doctors encounter.  As RD mentioned, there are people who seek meds from multiple doctors and sources, and the physicians have to deal with those individuals.

In all the information that I've obtained by respectable sources states that people who use pain medication for pain don't become addicted. That's a rare thing, the excpetion, not the rule. The correct term is "few" rather than "many."

I have a cousin who got into an auto accident, got addicted to pain meds, and died from an OD.  It happens.  Unfortunately I was out of the state at that time, and hadn't been aware of the issues until it was too late.

It is complicated, and addictive behavior may be due, in part, to poorly managed pain.

I tried to find some stats. 

Pain Patients. Opioids are the most abused drugs in the chronic pain setting [20]. The prevalence of lifetime substance use disorders ranges from 36% to 56% in patients treated with opioids for chronic back pain; 43% of this population has current substance use disorder (SUD) and 5% to 24% have aberrant medication-taking behaviors. About 14% to 16% of pain patients not having SUD use illicit drugs in combination with prescription drugs for pain, while 34% of patients with SUD combine legal pain medication with illicit drug use [20]. These statistics highlight the difficult situation of balancing pain treatment with abuse management. Studies show that increased monitoring of these situations does indeed decrease controlled substance abuse and illicit drug use.
The reference text:
Manchikanti L, Singh A. Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician. 2008(a);11(2 Suppl):S63-88.
http://www.painphysicianjournal.com/2010/september/2010;13;401-435.pdf

It is a fairly long review article.  I haven't gone through all the references, but as a review article, it does have a lot of referenced materials.

Quote from: Page 418 (18 of 36)
An epidemiological study from Denmark (174),
where opioids are prescribed liberally for chronic pain,
demonstrated worse pain, higher health care utiliza-
tion, and lower activity levels in opioid treated patients
compared to a matched cohort of chronic pain patients
not using opioids, suggesting that when opioids are
prescribed liberally, even if some patients benefit, the
overall population does not.

Overall, it appears that epidemiological studies are
less positive with regard to function and QOL [Quality of Life] and re-
port the failure of opioids to improve QOL in chronic
pain patients (277). By contrast, Eriksen et al (167) dem-
onstrated worse pain, higher healthcare utilization,
and lower activity levels in opioid-treated patients com-
pared with a matched cohort of chronic pain patients
not using opioids. Other studies have also shown that
instead of improving functional status, opioid use has
been associated with increased disability, medical costs,
subsequent surgery, and continued or late opioid use

Quote from: Page 419 (19 of 36)
5.1 Opioid Abuse in Chronic Pain
While proponents
claim extremely low levels of opioid abuse (296), opioids
are by far the most abused drugs, especially in chronic
pain management settings (4,12,19,25,36,37,46,144,2
34,235,280). Numerous investigations have illustrated
drug abuse in 18–41% of patients receiving opioids for
chronic pain (10,48,49,51-55,60,61,63-66,294,295,297).

Martell et al (48), in a systematic review of opioid
treatment for chronic back pain, estimated the preva-
lence of lifetime substance use disorders to range from
36 to 56%, with a 43% current substance use disorder
rate. Furthermore, aberrant medication-taking behav-
iors ranged from 5 to 24%.

It is easy to make generalizations, but one has to realize that each patient is different.  And, doctors and nurses should treat each patient as an individual too.

As noted earlier, there may be a group of individuals with "pseudo-addiction" who seem to express addictive behavior, but that behavior is due to poorly treated pain, and will usually go away with appropriate pain treatment. 

However, as the Danish study above indicated, the answers may not be in a bottle of pills.
 

Offline Pmb

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Re: Definition of "Drug seeking behaviour"
« Reply #6 on: 19/10/2013 19:01:52 »
Cliff - It wasn't my intention to get into a discussion about opiates. The sole reason for me creating this thread was to find a solid unambiguous defintion of drug-seeking. Too many doctors have leveled that name against me merely when I was seeking relief from horrible pain. The last time was so poorly done that I consider it slander. Before I take this to the next step and register a complaint against him with the board fo public health I need something solid to go by. If this thread goes astray with posts on opiate abuse I fear that nobody will focus on the actual purpose of this thread. Okay?
 

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Re: Definition of "Drug seeking behaviour"
« Reply #6 on: 19/10/2013 19:01:52 »

 

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