Clinical realities and economic considerations: Special therapeutic issues in intrathecal therapy - Tolerance and addiction Conference Paper
| Authors: | Portenoy, R. K.; Savage, S. R. |
| Title: | Clinical realities and economic considerations: Special therapeutic issues in intrathecal therapy - Tolerance and addiction |
| Conference Title: | Current Status of Intrathecal Therapy for Nonmalignant Pain Management |
| Abstract: | The long-term use of opioid analgesics in chronic nonmalignant pain has long been controversial. Rational discussion has been impeded by outdated research and myths regarding the risks of this therapy. Some of the misconceptions relate to the inappropriate use of the terms tolerance and addiction. Analgesic tolerance is a phenomenon in which exposure to the opioid itself causes the patient who has achieved analgesia to require a higher dosage to maintain the same level of effect. This appears to be very uncommon in the clinical setting. A need for dose escalation results from factors other than tolerance, including disease progression. Addiction is an association of psychological dependence and aberrant drug-related behaviors. Addiction to opioids in the context of pain treatment is rare in those with no history of addictive disorder. Clinicians need to become aware of the new findings regarding the low risk of addiction and tolerance in this setting. |
| Keywords: | dose response; drug withdrawal; conference paper; pain; drug dependence; opioids; analgesics, opioid; substance-related disorders; analgesia; drug tolerance; hyperalgesia; injections, spinal; analgesic agent; tolerance; opiate addiction; abstinence; addiction; intrathecal; withdrawal; opiate derivative; dose escalation; humans; human; intrathecal drug administration; psychological dependence |
| Journal Title | Journal of Pain and Symptom Management |
| Volume: | 14 |
| Issue: | 3 Suppl. 1 |
| Conference Dates: | 1997 Jan 9 |
| Conference Location: | Memphis, TN |
| ISBN: | 0885-3924 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1997-09-01 |
| Start Page: | S27 |
| End Page: | S35 |
| Language: | English |
| DOI: | 10.1016/s0885-3924(97)00168-1 |
| PUBMED: | 9291708 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Conference Paper -- Export Date: 17 March 2017 -- Source: Scopus |
