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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Analgesic drug abuse led to end-stage renal disease in 31% of 122 patients in a cross-sectional investigation at our center. Addiction to analgesics and tranquilizers remained a serious problem in these patients even after they were placed on chronic hemodialysis. There is strong evidence that drug addiction leading to end-stage renal disease and chronic hemodialysis correlates with a special type of personality typified by the 60-year-old depressive woman suffering from chronic headache.
Pain 1983 Sep
PMID:Analgesic dilemma in chronic hemodialysis patients. 663 15

Case studies describe a new type of addicted health professional whose opiate abuse originated recreationally . Historically, health professionals have had high rates of opiate addiction, usually viewed as an occupational hazard stemming from access and from self-treatment for pain or stresses of the medical profession. Partly because addiction in health professionals was almost always therapeutic (iatrogenic) or quasi-therapeutic (stress-related), it affected them less severely than it affected heroin addicts, whose drug abuse usually began recreationally . Now, however, because recreational drug abuse has become commonplace at American colleges since the mid-1960s, a majority of young health professionals have histories of abusing drugs and some are becoming non-therapeutically addicted. Six case studies describe this new addict type, showing how the subjects went from heavy soft drug use to opiate addiction, experienced severe longterm effects, were treated by society, and responded to treatment.
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PMID:Nontherapeutic opiate addiction in health professionals: a new form of impairment. 673 92

Recent attention to the management of cancer pain in the mass media (TV, books, newspapers) and the medical press provides ample evidence to suggest that many cancer patients are not receiving appropriate therapy for their pain. Since cancer therapy is often not curative, only palliative, specific attention to the management of pain in such patients is essential. However, the management of cancer pain requires a specific approach and expertise. Narcotic analgesics are the mainstay of therapy in the management of such patients, yet physicians lack sufficient knowledge of narcotic pharmacology to use these drugs appropriately. Recent controversy has arisen in 3 specific aspects of narcotic drug therapy: 1) the choice of a narcotic drug and its method of administration; 2) the development of tolerance, and 3) the risk of substance abuse, drug dependence, and addiction.
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PMID:Current issues in the management of cancer pain: Memorial Sloan-Kettering Cancer Center. 679 Oct 24

Narcotic maintenance may be needed to relieve chronic pain in ambulatory patients who fail to respond to other pain therapies. Oral, long-acting narcotics are preferred, and nonnarcotic pain therapies can be administered simultaneously to reduce the narcotic dosage. To legally undertake narcotic maintenance, the physician must document the presence of an incurable, painful medical condition. We recommend that the patient give informed consent, since narcotic maintenance may lead to dependence and addiction. When done properly, narcotic maintenance is an appropriate medical-legal procedure that is safe and may provide humanitarian pain relief.
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PMID:Narcotic maintenance for chronic pain. Medical and legal guidelines. 684

A controlled, double-blind study was performed to compare the new analgesic 4-(p-fluorophenyl)-1-isopropyl-7-methyl-2(1H)-quinazolinone (fluproquazone) (in the form of 100 mg and 200 mg capsules) with pentazocine 50 mg and placebo in 138 patients with post-neurosurgical pain. The efficacy of the compounds was tested on the basis of response to the initial administration of the stated doses and to repeated doses, the number of which depended on the individual needs of standardized interviews and the von Zerssen subjective rating, questionnaire, which provides information on the patients' mental and emotional status. Fluproquazone 200 mg and pentazocine 50 mg were equally effective. The effect of fluproquazone 100 mg was somewhat less marked but, nevertheless, significantly different from that of placebo. The importance of developing potent analgesics free of addiction potential as an alternative to the agents which act on the CNS is discussed.
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PMID:Comparison of the analgesic efficacy of fluproquazone, pentazocine and placebo against postoperative pain in neurosurgical patients. short communication. 697 88

Zomepirac sodium is a new oral analgesic that is more effective than aspirin, with no apparent tolerance or potential for addiction. It causes gastrointestinal bleeding similar to that caused by large doses of aspirin. For occasional moderate pain not responsive to aspirin, zomepirac may prove to be preferable to oral narcotics such as codeine, oxycodone, propoxyphene, pentazocine and meperidine. For chronic use, the safety and continued effectiveness of the new drug remain to be determined; it probably cannot replace oral narcotics in narcotic-dependent patients. For severe pain, as in myocardial infarction, renal colic and after some operations, zomepirac is no substitute for parenteral morphine.
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PMID:Zomepirac sodium -- a new oral analgesic. 700 39

Hemophilia represents a congenital hereditary disorder of blood coagulation characterized by recurrent unpredictable bleeding episodes affecting any body part, especially the joints and extremities. Repeated hemarthrosis eventually results in degenerative arthritis accompanied by severe chronic pain. As contrast to acute bleeding pain, which serves as a functional signal, chronic arthritic pain is a debilitating condition often resulting in analgesic abuse and/or addiction. Two adult hemophiliacs with severe chronic arthritis received training in progressive muscle relaxation exercise, meditative breathing, and imagery associated with past experiences of pain reduction. Imagery training resulted in clinically significant reductions in arthritic pain perception for both patients, maintained over an 8-month follow-up period. Concomitant Measures also demonstrated significant therapeutic gains. Thermal biofeedback assessment of the arthritic joint provided a biophysiological measure of learned temperature control through the imagery techniques. The findings are discussed in relationship to medical observations on the therapeutic value of warming and heat application in the management of arthritic joints, as well as other potential mechanisms which might have contributed in the reduction of arthritic pain perception. Finally, the importance of differentiating between acute bleeding pain management and chronic arthritic pain is emphasized, as well as the necessity of the application of the techniques within an interdisciplinary team setting.
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PMID:Behavioral medicine in hemophilia arthritic pain management: two case studies. 701 64

Data collected by the Quebec Board of Physicians show that during the 5 years from 1974 to 1978 the prevalence of addiction to opiates among Quebec physicians was 2.8/1000. The physician addicts had greater mobility and a higher attrition rate than their peers. The typical addict was male, a general practitioner and married. He often suffered from pain, fatigue, overwork, and financial and marital difficulties. His addiction had begun at approximately 35 years of age and had become evident about 3 1/2 years later. Meperidine was the preferred opiate. Some of the physicians lost their licences to practise for variable periods of time; for these the prognosis was gloomy. Depression was the main psychiatric disorder diagnosed.
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PMID:Drug addiction among Quebec physicians. 707 90

In a patient with postamputation pain a continuous self-stimulation of the mediothalamic system by a chronic deep brain electrode induced a change in behavior, similar to addiction. At the same time various psychological tests (HAWIE, Benton, Hooper-VOT and concentration tests) were significantly disturbed. After interruption of the deep brain stimulation all induced psychic abnormalities normalized within a few days.
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PMID:[Addiction-like behavior with continuous self-stimulation of the mediothalamic system (author's transl)]. 725 84

A retrospective review of 20 spine pain patients hospitalized between May 1977 and May 1979, who received pain cocktails was performed to determine the effectiveness of this manner of decreasing pain medication requirements. The primary objective of the pain cocktail is to reduce or eliminate addiction, habituation, and pain medication consumption. The pharmacist is responsible for regulating dosages, performing the compounding, and writing the orders for the pain cocktails. Gradual medication adjustments, based on the patient's need and tolerance, are made. Medication was reduced in 19 of the 20 patients. Twelve patients who started on narcotic analgesics and six who started on pentazocine had a final medication reduction of 71 percent and 51 percent respectively. Five of the 12 patients receiving narcotic analgesics in their initial cocktail were tapered to acetaminophen at time of discharge. Results were favorable and indicate the pain cocktail as a beneficial treatment modality for selected spine pain patients.
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PMID:The pain cocktail as an adjunctive agent in the treatment of spine pain patients. 733 91


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