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Nothing to Fear but Pain Itself

Are You Opio-Phobic?

Dependence Doesn't Equal Addiction continued...

"If the patient is started on an opioid and the dose is adjusted to a level where pain is adequately treated, the patient can be maintained on that same dose for the long-term," says Bennett. When a patient complains that pain has returned "it usually means that either the disease has progressed or there is something else, another condition," he says.

Moreover, Bennett says, even after years on opioids, patients can be taken off the drugs without fear of relapse. He points to one of his patients who took methadone for a painful hip defect. After many years the patient had hip replacement surgery, which freed him from the pain.

"We weaned him off the methadone and he has been methadone free for two years, no problem. Taking the drug did not make him an addict," says Bennett.

Why such a low risk of addiction with such powerful narcotics? It seems the body processes drugs differently when they're taken for genuine pain and when they're taken for recreational purposes.

"Patients without a history of addiction who actually have bona fide pain don't get high when they take these drugs for pain," says psychiatrist and addiction specialist Elizabeth Wallace, MD. For most pain patients OxyContin "relieves the pain but doesn't give the buzz," says Wallace, director of professional services at Professional Renewal Center, a drug treatment center in Lawrence, Kan.

It's yet another of the missing pieces of information that contributes to the opio-phobia phenomenon. Yet until both physicians and patients are educated about the real opioid story, such misinformation and fear will continue to stand in the way of "getting the job done: treating patients and their pain," says Bennett.


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