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Substance Abuse Issues In Cancer

Risk in Patients Without Substance Abuse Histories

In patients who do not have a history of drug abuse, the use of opioids to control cancer pain very rarely develops into a significant abuse or addiction problem. Patients and some health care professionals continue to have unfounded fears that opioid use for controlling cancer pain may become addictive when a more significant problem is the undertreatment of pain.

At one time it was assumed that many addictions originated from the use of drugs prescribed for pain. Because cancer patients are able to use opioids for cancer pain without experiencing significant problems, the risks and benefits of long-term opioid treatment for chronic pain that is not related to cancer needs to be reassessed. Three studies of over 24,000 patients without drug addiction histories who were being treated for burn, headache, or other pain, found opioid abuse in only 7 patients.

It is also suggested that the feeling of euphoria that a drug addict experiences does not happen in patients taking drugs to control pain. A patient taking opioids therapeutically more typically experiences a sense of depression rather than euphoria, thereby reducing the risk that the patient will become addicted to the drug.

The overall evidence indicates that in patients who do not have drug abuse or addiction histories, relationships with substance abusers, or psychological problems, the use of opioid therapy for control of chronic pain has a very low risk of developing into drug abuse or addiction. This is especially true for older patients who have never abused drugs.