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Titolo:
Abuse of opioid therapy in somatoform pain disorder. A contribution from apsychosomatic/pain therapist point of view to the discussion of the indication of opioids in nonmalignant pain based on 8 cases
Autore:
Wambach, S; Rohr, P; Hauser, W;
Indirizzi:
Funktionsbereich Psychosomat, Med Klin 1, D-66026 Saarbrucken, Germany Funktionsbereich Psychosomat Saarbrucken Germany D-66026 rucken, Germany Klinikum Saarbrucken GGMBH, Med Klin 1, Saarbrucken, Germany Klinikum Saarbrucken GGMBH Saarbrucken Germany 1, Saarbrucken, Germany Klinikum Saarbrucken GGMBH, Abt Schmerztherapie, Klin Anasthesiol & Oper Intens Med, Saarbrucken, Germany Klinikum Saarbrucken GGMBH Saarbrucken Germany ed, Saarbrucken, Germany
Titolo Testata:
SCHMERZ
fascicolo: 4, volume: 15, anno: 2001,
pagine: 254 -
SICI:
0932-433X(200108)15:4<254:AOOTIS>2.0.ZU;2-M
Fonte:
ISI
Lingua:
GER
Soggetto:
RISK-BENEFIT ASSESSMENT; SUBSTANCE-ABUSE; TRAMADOL; ANALGESICS; DEPENDENCE; ADDICTION;
Keywords:
opioid therapy abuse; nonmalignant chronic pain; somatoform pain disorder; eating, factitious and postraumatic stress disorder;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Hauser, W Funktionsbereich Psychosomat, Med Klin 1, Postfach 102629, D-66026 Saarbrucken, Germany Funktionsbereich Psychosomat Postfach 102629 Saarbrucken Germany D-66026
Citazione:
S. Wambach et al., "Abuse of opioid therapy in somatoform pain disorder. A contribution from apsychosomatic/pain therapist point of view to the discussion of the indication of opioids in nonmalignant pain based on 8 cases", SCHMERZ, 15(4), 2001, pp. 254

Abstract

We report 8 in-patients with nonmalignant chronic pain (main diagnosis: 7 somatoform pain disorders, 1 eating disorder) and with abuse of opioid therapy, which we have treated within 2 years in an tertiary centre. In all patients the inefficacy of opioids with regard to pain symptornatology could be demonstrated. Because the ICD-10 criteria of addiction cannot be fully applied to patients under opioid therapy because of chronic pain we suggest as criteria the intake of opioids because of positive psychotropic effects, the demand of high dosage of short acting opioids with inefficacy of similar long acting opioids dosage, the uncontrolled raising of dosage with illegal procurement and reluctance of the patient to stop opioid therapy becauseof proved inefficacy of pain control. These criteria applied 4% of all in-patients treated because of chronic pain and 30% of all in patients with somatoform pain disorder of our interdisciplinary unit fulfilled within two years the criteria of opioid therapy abuse. The risk of abuse of opioid therapy described in pain therapy literature for patients with substance abuse is also relevant for patients with somatoform pain disorder. Therefore a qualified psychotherapeutic evaluation before starting an opioid therapy for nonmalignant pain in order to exclude a somatoform pain disorder or to assess a substance dependency is mandatory. Patients with somatoform pain disorder should be treated with opioids only in clinical studies. A prior or present history of substance absuse given chronic opioid therapy for nonmalignant pain should only be performed in close cooperation of addiction- and pain therapists.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 23:03:01