Many pain patients taking opioids may engage in behaviors suggesting that
they are abusing the drugs, Steven Passik, Ph.D., an associate attending
psychologist at Memorial Sloan-Kettering Cancer Center, reported at a recent
pain, opioid, and addiction conference (see "Search Is On to Discover
'Perfect' Pain Killer"). He came to this conclusion after he and his
colleagues studied some 400 pain patients being treated with opioids and found
that 45 percent repeatedly engaged in some suspicious behaviors.
But even if patients act in aberrant ways related to opioid use, it does
not necessarily mean that they are actually abusing the drugs, he stressed.
However, if patients repeatedly engage in a suspect behavior over a six-month
period, then there is good reason to suspect that they are abusing the
And if misuse is likely occuring, it is crucial to determine why, Passik
said. Is the patient depressed, anxious, stressed, or perhaps selling the
medications for profit? It's very hard to detect patients with criminal
intent, he admitted.
Easier than detecting abuse of opioids, of course, is preventing it in the
first place, Passik noted. Thus pain patients should be screened for
opioid-addiction risk before being treated with them. There are several
screening instruments for such risk that can be administered quickly.
including the Opioid Risk Tool and the Screener and Opioid Assessment for Pain