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Article
February 9, 1994

Opiates for Pain: Patients' Tolerance and Society's Intolerance

Author Affiliations

National Institute on Drug Abuse Rockville, Md

JAMA. 1994;271(6):427. doi:10.1001/jama.1994.03510300027021
Abstract

To the Editor.  —The cloning of the μ opioid receptor is a breakthrough. It is unfortunate that the Medical News and Perspectives1 report on this contains misinformation about the use of opiates in the treatment of chronic pain. Unfortunate emphasis is given to the "possibility of finding a powerful analgesic that does not become so quickly tolerated by the body as does morphine, which could bring pain relief to people who suffer from chronic pain, patients who are not normally given morphine because of the problems of tolerance." This is not especially tantalizing to those of us familiar with the clinical treatment of (and literature on) chronic pain and drug dependence. Tolerance and physical dependence should not be barriers to use of opioids in the treatment of chronic pain.2,3The reason that patients with chronic pain are not given opiates when indicated is not tolerance but rather the

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