Analgesic and psychoactive drugs in the chronic pain patient

In contrast to the management of pain in patients with malignant disease, where manipulation of analgesic and psychoactive drugs may be necessary and effective, the elimination of drug use is a primary goal in programs for patients with chronic pain of benign rig in.; Drug use is often a significant component of pain behavior and, therefore, it is important to alter the use of drugs in freeing the patient of the chronic pain syndrome. Elimination of the unwanted side effects and medical complications of drug use may contribute significantly to the patient's physical and psychological well-being. Also, because many of these drugs are associated with physiological or psychological dependency, it also becomes important to identify and treat drug abuse and chemical dependency, which is a primary problem in a subgroup of chronic pain patients. This discussion will focus on the relationship of drug use to chronic pain behavior and methods of medication withdrawal. In addition, the problems of chemical dependency and its identification and management will be discussed.J Orthop Sports Phys Ther 1984;5(6):315-317.