The interface of pain and addiction is a common and vexing problem in clinical practice. This is complicated further by misunderstandings of distinctions between substance misuse, abuse, dependence, addiction, and pseudoaddiction.
Patients in pain may misuse a variety of substances to relieve their conditions.
Continued misuse can become harmful abuse, which may lead to physical and/or psychological dependence. Often patients develop “pseudoaddiction,” in which seemingly uncontrolled drug seeking is driven by self-attempted pain resolution rather than by the neurobiological disease of addiction.
This section of Pain Treatment Topics focuses on the clarification, identification, prevention, and treatment of addictive disorders within the context of pain and, conversely, on pain management in persons with a history of addiction.
o Pain in Opioid-Addicted Patients Entering Addiction Treatmento ASPMN Position Statement: Pain Management in Patients with Addictive Diseaseo American Society for Pain Management Nursing (ASPMN), September 2002. o Definitions Related to the Use of Opioids for the Treatment of Pain (including clarifications of addiction)o
Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine. 2001o EUROPAD Journal on Addictiono Heroin Addiction and Related Clinical Problems — full editions available for download as PDF documents.