To the Editor.—Dr Portenoy and colleagues1 have opened the door for an exploration of the
interface between pain management and addiction. As physicians, we find ourselves
in murky waters indeed, especially when dealing with the family of drugs classified
as opiates. Can a clear distinction be made between the physical pain of a
medical patient and the psychological pain of an addict? Often, problems begin
in physicians' offices with prescribing narcotic pharmaceuticals. Heroin addicts
use these same medications when their drug of choice is unavailable.2 With the use of opiates, does euphoria overlap
with analgesia? Even the patient may not be sure.
Murphy DJ. Pain Management and Chemical Dependency. JAMA. 1998;279(1):17–18. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-1-jlt0107
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