Risk in Patients Without Substance Abuse Histories
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.
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