Diagnosing addictive disease in chronic pain patients.
As opiate therapy is increasingly accepted for the management of chronic pain, the consultation-liaison psychiatrist is often challenged to diagnose and provide treatment recommendations for addictive disease in chronic pain patients. Reviewed are the defining characteristics of addiction within the context of chronic pain, and the interesting commonalities between addictive disease and chronic pain. Guidelines for assessment of addiction in patients with chronic pain are presented, as are suggestions for the management of these concurrent disorders. Underlying this review is a belief that opiates should not be withheld from persons with chronic pain, even in the presence of addictive disease.
Miotto
K
K
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
Compton
P
P
Ling
W
W
Conolly
M
M
D002908:Chronic Disease; D006801:Humans; D009294:Narcotics / Q000627:therapeutic use; D010146:Pain / Q000150:complications* / Q000188:drug therapy; D011570:Psychiatry; D012017:Referral and Consultation; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis*
D009294:Narcotics