Opium Abuse among Patients with Chronic Physical Pain as a Misleading Cause in Addiction Treatment Center

Document Type : Research Paper

Authors

1 Assistant professor of Physical Medicine and Rehabilitation, Jundishapur university of Medical sciences, Ahvaz, Iran

2 MPH &Lecturer in public health, Jundishapur university of Medical Sciences, Ahvaz, Iran

3 Assistant professor of psychiatry, Jundishapur University of Medical sciences, Ahvaz,Iran

Abstract

Introduction
 
Chronic non-cancer pain has been considered as causes of Opium addiction in human beings. The knowledge of its incidence as an initial reason for Opium consumption among Opium addict people may affect a) addiction prevention plans, b) addiction treatment programmes and even 3) educational goals for training medical students. Therefore,this study aimed to determine this incidence among Opium addict people referred to an addiction treatment center.
 
Materials and Methods
 
This is a cross sectional study which was performed in Ahwaz during 2006-2008.First, a pilot study was carried out in which the study sample size was calculated. Participants were evaluated by physical examination, pain scaling via VAS, physical examination and psychological interview based on DSM4 criteria and SCL90 questionnaire. The obtained data were analyzed by descriptive analysis of SPSS and χ square test.
 
Results
 
Finally, 21 patients out of 224 participants were found to suffer from a type of chronic physical pain before Opium addiction. Psychological abnormalities were more frequent in pain suffered patients (p<0.007).
 
Conclusion
 
There were some people who seek for getting rid of physical pain. But, they were deviating to a street drug abuse status. This issue should be considered in prevention and treatment of addiction.

Keywords


1- Seifollahi H. The evaluation of addicted women social and economical status whom were arrested in Tehran. Ann
Res J Shahid Behshti Univ Med Sci 1994; 15-20.
2- Ashrafi Zadeh S. The evaluation of economical and social factors affecting 15-20 years old young people to be
afflicted in addiction in Ahwaz. The report of a research project in Ahwaz Jundishapour University of Medical
Sciences. 2003; 60-87.
3-Momtazi S. Families and addiction. Economical and social problems among families Tehran. 2002; 101-140.
4- Jackson T. Acute and chronic pain-in: practical manual of physical medicine and rehabilitation. Mosby; 1998p.607-644.
5- Goldman B. Acute pain in: Managing Pain. Health Care &Financial publishing, Rogers's media; 2002.p.87-103.
6- Taub A. Opioid analgesics in the treatment of chronic intractable pain of non-neoplastic origin. In: Kitahatalin,
collins D. Narcotic analgesics in anaesthesidogy. Baltimore:Williams&Willkins; 1982;.p.199-208.
7- France R, Urban B, Keefe F. Long term use of narcotic analgesics in chronic pain. Soc Sci Med 1984:1379-82.
8- France R, Urban B, Keefe F. Long term use of narcotic analgesics in chronic pain.J Pain Symp Manage 1992;7:69-77.
9- Tennant J, Robinson D, Sagherian A , Secaf R. Chronic opioid treatment of intractable non- cancer pain. NIDA Res
Manogr 1988; 81:174-180.
10- Portenoy R. Opioid therapy for chronic non – malignant:A review of the Critical Issues. Pain Res manage 1996;
11:203-217.
11- Strumpf M, Tryba M. long term oral opioid therapy in patient with chronic non-malignant pain. J pain symp
manage 1992; 7:69-77.
12- Arkinstall W, Sandler A,Geoghnour B, Babul N, Horsanyi Z, Darke A. Efficacy of controlled- release codein in
chronic non-malignant pain: a randomized, placebo – controlled clinical trial . Pain 1995; 62:196-178.
13- Peloso PM, Bellamy N, Bensen W, thomson GT,Harsonyiz Babul N, Darke AC. Double blind randomised
Placebo controutrial of controlled release codein in the treatment of osteoarthritis of the hip or knee. J
Rheumatol 2000; 27:764-771.
14- Noorbala A, Fakhraie S. Surveying the frequency of psychiatric symptoms among senior medical and nonmedical
students of Tehran University. J Thought Behav 2001; 30-38.
15- Kaviani H, Moosavi A, Moin A. Psychological interview and tests. Fana 1388; 250-255.
16- Mailis GA. Opioid use And Abuse: Is There a problem? Clin J Pain 2007; 23: 661-662.
17- Mercadante S. Opioid rotation for cancer pain: rationale and clinical aspects. Cancer 1999; 86:1856 -1866.
18- Mancini I, Lossignol D, Body J. Opioid switch to oral methadone in cancer pain. Curr Opin Oncol 2000; 12:308 -313.
19- Quigley C. Opioid switching to improve pain relief and drug tolerability. Cochrane Database Syst Rev 2004;
:CD004847.
20- Morita T,Takigawa C, Onishi H, Tsukasa T, Kazuhiko T, Tatsuhiko M, et al. Opioid rotation from morphine to
fentanyl in delirious cancer patients. J Pain Symp Manage 2005; 30:96-103
21- Rettig R, Yarmolinsky A. eitors. Federal regulation of methadone treatment. In: The committee report on
federation regulation of methadone treatment. Washington, DC: The National Academic Press; 1995.p.88-112.
22- Morgan J, Pleet D. Opioidphobia in the United States: the under-treatment of severe pain. In: Morgan J, Kagan D,
editors. Society and medication: conflicting signals for prescribers and patients. Lexington: Lexington Press; 1983.p. 3343.
23- Melzack R. The tragedy of needless pain. Science 1990; 262:27–33.
24- Roman D. Barriers to Opium Pain Management. In: Managing Pain. Toronto: Health Care and Financial
Publishing; 2002.p.1-6.
25- Bell K, Salmon A. Pain, physical dependence and pseudoaddiction: Redefining addiction for nice people? Int J
Drug policy 2009; 20:170-178.
26- Lusher J, Elander J, Bevan D, Talfer P, Burton B. Analgesic addiction and pseudoaddiction in painful chronic
illness. Clin J Pain 2006; 22:316-324.
27- Shahri G, Tahsildoost F, Samadi Ahari M, Kakai Afshar H, Rahimi Esfahani A. Psycho trope drugs. In: The
Iranian penal code. Vol 2. Tehran; Vice chairman in judicature; 2009.p.1465-1473.
28-Mailis-Gagon A.What's hurting Alex? In: Mailis-Gagon A, Israelman D. Beyond Pain. 2ed ed. University of
Michigan Press; 2005.p.21-40.
29- Price S. Osteoarthritis: A single genetic factor determines propensity to report musculoskeletal pain at multiple
sites. Nat Rev Rheumatol 2010; 6:438.
30- Nissenbaum J, Devor M, Seltzer Z, Gebauer M, Michaelis M, Tal M, et al. Susceptibility to chronic
pain following nerveinjury is genetically affected by CACNG2.Genome Res. Available
at:www.genome.org/cgi/doi/10.1101/gr.104976.110(2010).