The use of opioids has long been accepted as the standard of care in patients
with cancer and acute pain. Opioids can further be used effectively in specific
subgroups of patients with chronic nonmalignant pain states. While the development
of tolerance and physical dependence are known effects of opioids in cancer
and noncancer pain populations, these patients can not be regarded as addicted.
However, long-term therapy with short-acting opioids predisposes to tolerance
and addiction. Recent research has confirmed the important role of psychopathologic
and psychosocial conditions as predictors of failed opioid effectiveness in
a significant number of noncancer pain subgroups. The clinical picture of failed
therapy may be complicated by noncompliance, concealed consumption of psychotropic
substances, and diversion of prescribed opioids for various purposes as, e.g.,
selling for profit, or sharing excess opioids with others. This article discusses
the effects of opioid therapy, including tolerance, physical dependence, drug-aberrant
behavior, drug history, psychopathology, and somatization.
Jage J. Eur J Pain. 2005 Apr;9(2):157-62.
PMID: 15737807 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15737807
Credit: All abstracts retrieved from PubMed, developed by the National Center for
Biotechnology Information (NCBI) at the
National Library of Medicine (NLM).
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