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Opioid pseudoaddiction--an iatrogenic syndrome.
David E Weissman1, David J Haddox
1Division of Hematology / Oncology, Medical College of Wisconsin, Milwaukee, WIU.S.A. Departments of Anesthesiology and Psychiatry, Medical College of Wisconsin, Milwaukee, WIU.S.A.
Pain
|March 1, 1989
Summary
Pseudoaddiction, a syndrome of abnormal behavior due to inadequate pain management, can occur in patients with severe pain. Effective pain control and trust-building are key to managing this iatrogenic condition.
Area of Science:
- Medical Case Study
- Pain Management
- Oncology
Background:
- This case highlights a 17-year-old leukemia patient experiencing significant chest-wall pain due to pneumonia.
- Inadequate pain management led to behavioral changes mimicking opioid dependence.
Observation:
- The patient exhibited escalating analgesic demands and behavioral changes, indicative of distress.
- These behaviors were a direct consequence of insufficient pain relief, not addiction.
Findings:
- The study introduces the term 'pseudoaddiction' to describe iatrogenic abnormal behaviors from poor pain management.
- Pseudoaddiction progresses through phases: inadequate analgesia, escalated demands, and mistrust.
- Effective treatment involves establishing trust and optimizing pain management.
Implications:
- Recognizing pseudoaddiction is crucial for appropriate patient care and avoiding misdiagnosis of addiction.
- Improved pain management strategies can prevent the development of pseudoaddiction.
- This concept emphasizes the importance of patient-centered care in managing complex pain conditions.