SEVERE OPIOID TOXICITY AND SOMATIZATION OF PSYCHOSOCIAL DISTRESS IN ACANCER-PATIENT WITH A BACKGROUND OF CHEMICAL-DEPENDENCE

A case of severe opioid toxicity is described in a 52-year-old cancer patient. The patient presented with classical clinical features of cen tral hyperexcitability associated with opioid toxicity: delirium, myoc lonus, hallucinations, hyperalgesia, and a possible seizure. This pati ent had a background of severe psychosocial distress and somatization in addition to a history of benzodiazepine dependence and alcohol abus e. The occurrence of opioid toxicity in this patient highlights the ri sks of a unidimensional approach to cancer pain, which ignores the non -organic components of pain, such as psychosocial distress, which will not respond to escalating doses of opioid medication. (C) U.S. Cancer Pain Relief Committee, 1997.