Word: painful
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Which Painkiller Is Right? One opioid is associated with a significantly higher risk of overdose than other drugs: methadone, which is being used increasingly to treat chronic pain because it is cheaper and draws less scrutiny than other strong, long-acting opioids like Oxycontin...
...review published in the Jan. 20 issue of the Cochrane Database of Systematic Reviews, a leading evidence-based-medicine journal, researchers found that only one-third of 1% of chronic-pain patients without a history of substance problems became addicted to opioids during treatment. The review included 4,893 mostly middle-aged chronic-pain patients, who were treated with opioids for between six months and four years. "This suggests that people who do not have a history of drug abuse or addiction are not highly like to develop [addiction] under physician care," says Meredith Noble, lead author of the review...
...some cases, however, undertreated pain may contribute to a situation that looks like addiction; patients ask for higher and higher doses and appear to be drug-seeking, when in fact they are looking for effective pain relief...
...Overdose Problem For the most recent study of overdose risk, researchers examined the medical records of nearly 10,000 chronic-pain patients being treated within a Washington State health plan between 1997 and 2005. Published in the Annals of Internal Medicine in January, the study found that 51 patients had experienced overdose - six of them fatal. The overall risk of overdose was small, but it was clearly associated with the dose of the medication originally prescribed: patients receiving the highest doses were nearly nine times more likely to overdose than patients on the lowest doses. "The overall risk among people...
...overdose cases involved known drug misuse or suicide attempts, while others were due to patient error, but the study could not identify exactly what went wrong in all of the cases. Was it the high-prescribed dose alone, or were there other risk factors like illness, escalation of pain or undiagnosed addiction? While Von Korff and Volkow agree that prescription dose is a major contributor to overdose risk, they say better studies are needed to determine the precise causes and consequences. "One would hope that for a treatment regimen that millions of people are using, we'd have large, long...