Medications of abuse in pain management.
OBJECTIVE
Chronic pain leads to a reduction in the quality of life for those who suffer it. Due also to high medical costs and lost productivity, chronic pain is a significant burden on society. One contributor to the burden of pain is the fear that medications used in pain management produce dependency, leading to diversion and addiction. Certain medications used in practice, although not abused by the patient, seem to be favored and these are frequently reported to be used recreationally by the nonpatient population. This report identifies medications that most frequently present a problem in pain practices, why they are a problem, and possible alternatives to their use.


RESULTS
Problem medications used in analgesic regimens tend to be those that have rapid onset due to their lipophilic nature or route of administration, short duration, and a sedating or energizing effect. These medications are generally more affordable than alternatives with less abuse potential. These medications are more often covered by insurance and more frequently prescribed. Changes in prescribing habits have resulted in predictable shifts in abuse.


CONCLUSIONS
Addiction and diversion of prescription medications is a multidimensional problem. Its multifactorial solution will require efforts at many regulatory levels.
Flugsrud-Breckenridge
Marcia R
MR
Department of Neurology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Gevirtz
Clifford
C
Paul
Dennis
D
Gould
Harry J
HJ
D000700:Analgesics; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D019966:Substance-Related Disorders / Q000517:prevention & control*; D014481:United States
D000700:Analgesics