Another situation can occur in which patients with unrelieved, real pain exhibit behaviors that suggest addiction. Termed pseudoaddiction, This behavior can mimic that of true addiction, including illicit drug use, lying, and manipulation in an attempt to relieve their pain (Savage 2003). Pseudoaddiction can be distinguished from true addiction by the cessation of drug-seeking behaviors when effective analgesia is achieved via opioid or non-opioid means. A patient with true addiction will continue drug-seeking behaviors despite appropriate increases in pain treatment modalities or may acquiesce for a short while, but soon commences drug-seeking behavior again, as the disease of addiction progresses.

Ultimately, it is close observation, vigilance, detailed documentation, and good clinical judgment that will enable the clinician to determine the presence of such behaviors.

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