The use of opioid drugs for the management of acute pain states and for the management of pain associated with cancer is well established. There is now a considerable and wide-ranging literature on the use of these drugs in persistent pain conditions not associated with malignant disease.1 The concerns of clinicians regarding the propensity of these drugs to cause problems of tolerance, dependence, and addiction remain largely unanswered. These concerns become sharply focused when prescribing opioid analgesic drugs for patients in pain who have a past or current history of substance misuse.2

This chapter outlines the burdens of substance misuse to individuals and society and discusses the relevant neurobiology in order to explain why use of opioid drugs may lead to medical and legal problems. Definitions of addiction, dependence, and tolerance to opioid drugs in the context of pain management are discussed and data regarding risks of iatrogenic problem drug use are presented. The discussion supports the safe use of opioids for long-term pain control by giving guidance on identification and management of problem drug use and outlines principles of management of persistent pain in patients with addictive disease.

Naturally Cure Your Headaches

Naturally Cure Your Headaches

Are Headaches Taking Your Life Hostage and Preventing You From Living to Your Fullest Potential? Are you tired of being given the run around by doctors who tell you that your headaches or migraines are psychological or that they have no cause that can be treated? Are you sick of calling in sick because you woke up with a headache so bad that you can barely think or see straight?

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