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Opioid pseudoaddiction — an iatrogenic syndrome
Abstract
A case is presented of a 17-year-old with leukemia, pneumonia and chest-wall pain. Inadequate treatment of the patient's pain led to behavioral changes similar to those seen with idiopathic opioid psychologic dependence (addiction). The term pseudoaddiction is introduced to describe the iatrogenic syndrome of abnormal behavior developing as a direct consequence of inadequate pain management. The natural history of pseudoaddiction includes progression through 3 characteristic phases including: (1) inadequate prescription of analgesics to meet the primary pain stimulus, (2) escalation of analgesic demands by the patient associated with behavioral changes to convince others of the pain's severity, and (3) a crisis of mistrust between the patient and the health care team. Treatment strategies include establishing trust between the patient and the health care team and providing appropriate and timely analgesics to control the patient's level of pain.
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Citations
Cites
Addiction Rare in Patients Treated with Narcotics
(1980) · New England Journal of Medicine · doi:10.1056/nejm198001103020221 · Cited by 1,106
Cited by
Pergolizzi, J., Böger, R. H., Budd, K., Dahan, A., Erdine, S., Hans, G., Kress, H., Langford, R., Likar, R., Raffa, R. B., et al. (2008) · Pain Practice · doi:10.1111/j.1533-2500.2008.00204.x · Cited by 854
Addiction to opioids in chronic pain patients: A literature review
Højsted, J., & Sjøgren, P. (2007) · European Journal of Pain · doi:10.1016/j.ejpain.2006.08.004 · Cited by 424
Alcohol dependence as a chronic pain disorder
Egli, M., Koob, G. F., & Edwards, S. (2012) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2012.07.010 · Cited by 347
Common brain mechanisms of chronic pain and addiction
Elman, I., & Borsook, D. (2016) · Neuron · doi:10.1016/j.neuron.2015.11.027 · Cited by 303
Buprenorphine: Considerations for Pain Management
Johnson, R. E., Fudala, P. J., & Payne, R. (2005) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2004.07.005 · Cited by 290
Metadata
- Authors
- Weissman, D. E., & Haddox, D. J.
- Venue
- Pain
- Published
- 1989-03
- Volume
- 36
- Issue
- 3
- Pages
- 363-366
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W1996834041
- Cited by
- 647
- References
- 1
- FWCI
- 6.15
- Type
- journal article
- Language
- en
- Open access
- closed
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- Weissman, D. E., & Haddox, D. J. (1989). Opioid pseudoaddiction — an iatrogenic syndrome. Pain. https://doi.org/10.1016/0304-3959(89)90097-3
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
