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January 7, 1998

Pain Management and Chemical Dependency

JAMA. 1998;279(1):17-18. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-1-jlt0107

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.