In patients who do not have a history of drug abuse, the use of opioids to control cancer pain very rarely develops into a significant abuse or addiction problem. Patients and some health care professionals continue to have unfounded fears that opioid use for controlling cancer pain may become addictive when a more significant problem is the undertreatment of pain.

At one time it was assumed that many addictions originated from the use of drugs prescribed for pain. Because cancer patients are able to use opioids for cancer pain without experiencing significant problems, the risks and benefits of long-term opioid treatment for chronic pain that is not related to cancer needs to be reassessed. Three studies of over 24,000 patients without drug addiction histories who were being treated for burn, headache, or other pain, found opioid abuse in only 7 patients.

It is also suggested that the feeling of euphoria that a drug addict experiences does not happen in patients taking drugs to control pain. A patient taking opioids therapeutically more typically experiences a sense of depression rather than euphoria, thereby reducing the risk that the patient will become addicted to the drug.

The overall evidence indicates that in patients who do not have drug abuse or addiction histories, relationships with substance abusers, or psychological problems, the use of opioid therapy for control of chronic pain has a very low risk of developing into drug abuse or addiction. This is especially true for older patients who have never abused drugs.

Glossary Terms

Uncontrollable craving, seeking, and use of a substance such as a drug or alcohol.

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

Pain that can range from mild to severe, and persists or progresses over a long period of time.

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.

The use of illegal drugs or the use of prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in large amounts. Drug abuse may lead to social, physical, emotional, and job-related problems.

A feeling of great happiness or well-being. Euphoria may be a side effect of certain drugs.

A substance used to treat moderate to severe pain. Opioids are like opiates, such as morphine and codeine, but are not made from opium. Opioids bind to opioid receptors in the central nervous system. Opioids used to be called narcotics. An opioid is a type of alkaloid.

The use of illegal drugs or the use of prescription or over-the-counter drugs or alcohol for purposes other than those for which they are meant to be used, or in excessive amounts. Substance abuse may lead to social, physical, emotional, and job-related problems.

Having to do with treating disease and helping healing take place.

Treatment.