[Drug dependence and withdrawal in chronic pain patients]

Drug dependence in "pain patients" usually involves primary headache syndromes with chronicity resulting from the use of analgesic-psychotropic or ergotamine-containing combination preparations. Since, during the withdrawal phase, enhancement of pain intensity together with other abstinence phenomena are to be expected, hospitalization is usually indicated. Psychosomatic pain syndromes with dependence on benzodiazepine derivatives represent the second largest group. In these patients, withdrawal is effected stepwise, usually on an outpatient basis. Opioid analgesics administered to patients to treat chronic pain do not necessarily lead to the development of tolerance. Occasionally, dependency is observed in organic or psychosomatic pain states. In all three groups, typical addition behavior is rare.