Dependence and addiction in chronic non-cancer pain patients under chronic opioid therapy

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  • HIROSE Munetaka
    Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui
  • TABATA Mari
    Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui
  • SAKAI Mikako
    Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui

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  • 慢性非がん性痛患者における長期オピオイド療法による依存と嗜癖
  • マンセイ ヒガンセイツウ カンジャ ニ オケル チョウキ オピオイド リョウホウ ニ ヨル イソン ト シヘキ

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Abstract

Although chronic opioid therapy (COT) is effective for chronic non-cancer pain, it may cause opioid dependence or addiction. The term addiction which is characterized by compulsive opioid use and craving for opioid, includes psychological dependence but not physical dependence and tolerance. On the other hand, the term dependence includes all three factors. When the dose of opioid increases gradually in a chronic pain patient, who shows no aberrant use of opioid, the patient may display not addiction but dependence. The term addiction, however, has often been confused with dependence. Here we report how this confusion has obstructed research on addiction caused by COT. Although several guidelines of COT for preventing addiction in patients with chronic non-cancer pain were introduced recently, they include some flaws. The present report provides valuable information concerning dependence and addiction for medical associates providing COT.

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