Pseudoaddiction
Doctors are always wary of people who appear to be drug seeking, saying they need more medication sooner than predicted, or trying several different doctors to get medication. While this can be a warning sign of someone who is abusing their medication, it can also be a sign of someone who is not getting sufficient pain relief. This is called pseudoaddiction. In general, people with pseudoaddiction can be differentiated from genuine addicts by the history of their pain problem and screening tests for addiction risk factors.
Substance abuse and chronic pain
Some people with substance abuse problems also have chronic pain from various conditions. They also deserve pain relief and should not be denied opioid treatment if the pain warrants it. For instance, many people with AIDS have pain. They may have contracted the disease through intravenous drug use, and although their management can be difficult, they deserve to have good pain relief.
Cancer and other chronic pain conditions
In the treatment of most chronic pain and for cancer pain, a regular dose of morphine is given. In cancer pain the dose of morphine often needs to increase as the disease progresses. People often worry that a higher number of doses mean that the medication is losing its effectiveness or that they will become addicted - this is not the case. The dose needed to control the pain is the dose that should be taken, and it will vary widely from person to person. Many people will take opioids for years, and if the cause of their pain remains stable, their dose of morphine remains stable as well.
Do opioids cause you to lose concentration and affect your ability to think? For a lot of people they do, in the first few days of starting the medication or increasing the dose. However, the body rapidly adapts, and studies of people who use morphine regularly for pain do not show any reduced ability to think or concentrate. Many people who adjust to morphine continue to drive, work, and travel. They function much better than before because their pain is controlled. Some people, however, may not adjust to the morphine and find themselves feeling groggy. If this occurs, the dose is too high or other medical conditions may be interfering with the metabolism of morphine making it unsuitable for them.
Much research still needs to be done on opioid medications and how we can make the best use of them and reduce side effects. Pain relievers that are as effective as opioids, but without addiction potential, would be a wonderful help to those who are at risk for addiction.