[Problems of pain medication and dependence]

Based on the experience in a psychosomatic clinic, drug dependency problems among chronic pain patients are reported. The following three theses have evolved: 1. By far most important of all is the problem of tranquilizer abuse, which entails serious, and sometimes dramatic, withdrawal syndromes. An indication for continuous tranquilizer medication does not exist. 2. Compound preparations are problematical, in particular if they contain codeine. We frequently see abuse and even dependence. 3. Opium derivatives continue to be rarely prescribed in non-cancer chronic pain. Several instances of incorrect pain management have been found, such as prescription to substance abusers, on insufficient indication, or prescription on request instead of time-schedule therapy.