UI - 000251

AU - Weissman DE

AU - Haddox JD

TI - Opioid pseudoaddiction--an iatrogenic syndrome

AB - AB - A case is presented of a 17-year-old with leukemia, pneumonia and chest-wall pain. Inadequate

treatment of the patient's pain led to behavioral changes similar to those seen with idiopathic opioid

psychologic dependence (addiction). The term pseudoaddiction is introduced to describe the iatrogenic

syndrome of abnormal behavior developing as a direct consequence of inadequate pain management. The

natural history of pseudoaddiction includes progression through 3 characteristic phases including: (1)

inadequate prescription of analgesics to meet the primary pain stimulus, (2) escalation of analgesic demands

by the patient associated with behavioral changes to convince others of the pain's severity, and (3) a crisis of

mistrust between the patient and the health care team. Treatment strategies include establishing trust

between the patient and the health care team and providing appropriate and timely analgesics to control the

patient's level of pain AD - Division of Hematology/Oncology AD - Medical College of Wisconsin AD -

Milwaukee 53226 UI - 89220105

SO - Pain 1989;36:363-366