DIAGNOSING ADDICTIVE DISEASE IN CHRONIC PAIN PATIENTS

As opiate therapy is increasingly accepted for the management of chron ic pain, the consultation-liaison psychiatrist is often challenged to diagnose and provide treatment recommendations for addictive disease i n chronic pain patients. Reviewed are the defining characteristics of addiction within the context of chronic pain, and the interesting comm onalities between addictive disease and chronic pain. Guidelines for a ssessment of addiction in patients with chronic pain are presented, as are suggestions for the management of these concurrent disorders. Und erlying this review is a belief that opiates should not be withheld fr om persons with chronic pain, even in the presence of addictive diseas e.