Propoxyphene on demand. Analgesic-seeking behavior in psychiatric inpatients

Although anxiety is known to enhance a patient's response to pain, the exact relationship is unclear. This problem is particularly acute among psychiatric patients where analgesics are frequently both used and abused. This study attempts to evaluate factors associated with analgesic use among these patients with the hypothesis that anxiety, other measures of psychopathology, and ward tension would be associated with frequent analgesic use. An unselected series of psychiatric admissions during a three month period were administered the State-Trait Anxiety Inventory, MMPI, and a questionnaire dealing with prior drug use. Propoxyphene napsylate (Darvon-N) was made freely available on request from nurses who recorded details of the interaction on a prepared card. The nursing staff also recorded unusual incidents on the unit and evaluated daily the level of ward tension. The results indicate that, when made freely available to psychiatric inpatients, propoxyphene was used very conservatively and for appropriate complaints. Factors associated with drug seeking behavior are discussed in relation to other research regarding the use and abuse of analgesics.