Opioid Therapy for Chronic Pain and Drug Addiction Easily Confused

According to Peggy Compton, RN, PhD, and professor of nursing at UCLA, a study at the pain clinic there showed approximately 28% of patients were thought to have medication misuse issues with opioid therapy. These patients were discharged from the clinic because of their related behaviors.

However, Compton goes on to assert that researchers are not really sure if all 28% of the discharged patients actually had a substance abuse problem. She says there are other behaviors that are easy to interpret as substance abuse – which is marked by “drug seeking” – such as inadequate pain relief with the current therapy, a psychiatric disorder or general noncompliance.

According to Compton, one inherent problem is that the criteria used to mark someone as “addicted” has been determined by studies done on (otherwise) healthy people – those without chronic pain. So now, doctors and researchers use the criteria to decide if a person who lives with pain much or all of the time and is on opioid therapy because of it is “addicted”. Fair? Realistic? I think not.

Compton says that treating addiction in a pain patient or vice versa is counterproductive when only one is addressed in the treatment plan. Each of these conditions affects other dimensions of life, and therapy goes nowhere if one is left out. She suggests that pain management specialists be involved in their patients’ substance abuse treatment, and that discharging them because of possible addiction is unhealthy, not only for the patient, but also their families, the healthcare system and society at large.

_{Source:
Compton, P., RN, PhD. Should Opioid Abusers Be Discharged from Opioid-Analgesic Therapy? Pain Treatment Topics website. Jan. 2008.}