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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.
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.
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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.
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.
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."
Pain Patients. Opioids are the most abused drugs in the chronic pain setting . 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 . 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.
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 patientscompared to a matched cohort of chronic pain patientsnot using opioids, suggesting that when opioids areprescribed liberally, even if some patients benefit, theoverall population does not.Overall, it appears that epidemiological studies areless positive with regard to function and QOL [Quality of Life] and re-port the failure of opioids to improve QOL in chronicpain 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 patientsnot using opioids. Other studies have also shown thatinstead of improving functional status, opioid use hasbeen associated with increased disability, medical costs,subsequent surgery, and continued or late opioid use
5.1 Opioid Abuse in Chronic PainWhile proponentsclaim extremely low levels of opioid abuse (296), opioidsare by far the most abused drugs, especially in chronicpain management settings (4,12,19,25,36,37,46,144,234,235,280). Numerous investigations have illustrateddrug abuse in 18–41% of patients receiving opioids forchronic pain (10,48,49,51-55,60,61,63-66,294,295,297).Martell et al (48), in a systematic review of opioidtreatment for chronic back pain, estimated the preva-lence of lifetime substance use disorders to range from36 to 56%, with a 43% current substance use disorderrate. Furthermore, aberrant medication-taking behav-iors ranged from 5 to 24%.