![]() ![]() Addiction as defined by the compulsive, harmful use criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition is common among recreational opioid users, but relatively rare in chronic pain patients ( Cowan et al., 2001). Clinically, more than 10-fold dose escalations of opioid dose in chronic pain management are common ( Buntin-Mushock et al., 2005) and yet, many studies show that relatively stable doses of opioids can provide pain relief for weeks or years ( Eisenberg et al., 2005 Farrar et al., 2010). Opioid tolerance is characterized by a reduced responsiveness to an opioid agonist such as morphine and is usually manifest by the need to use increasing doses to achieve the desired effect. The development of tolerance, dependence and addiction during chronic opioid use further limit the clinical utility of these drugs. Unfortunately, opioid use is limited by serious adverse effects such as respiratory depression, sedation and constipation. Opioids are the most effective treatment for pain. ![]()
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