Navigating opioid use in chronic noncancer pain conditions: A case series on pseudoaddiction

Abstract

Opioid prescriptions for chronic non-cancer pain raise concerns of addiction risks. Understanding the nuanced intersection of chronic pain and opioid use is crucial in clinical settings. We present four case studies from two tertiary care hospitals illustrating the phenomenon of “pseudoaddiction” in CNCP referred to addiction specialists for management. Each case involves complex pain presentations like pancreatitis, avascular necrosis, and SLE intertwined with escalating opioid demands. Management involved psychoeducation, CBT, and opioid substitution, resulting in reduced pain and need for opioids. Differentiating between addiction and uncontrolled pain is crucial for tailored management, emphasizing individualized care for improved outcomes.

Keywords

• addiction
• chronic noncancer pain
• cncp
• consultation-liason
• opioid
• pain
• pseudoaddiction
• somatoform
• substance use