On Wed, 29 Sep 1999, Rick Froman went:
> In my Intro Psych text, Exploring Psychology, Myers cites Melzack
> (1990) in a Scientific American article as saying that people don't
> usually become addicted to (or at least develop cravings for) drugs
> used to control chronic pain. John Graham, in a book I just
> received titled, MMPI-2: Assessing personality and psychopathology
> (3rd ed.), cites Fordyce (1979) in article on the use of the MMPI in
> assessing chronic pain, as suggesting "that chronic pain patients
> can easily become addicted to narcotics, barbiturates, or muscle
> relaxants." (p.232 in Graham). Both of these secondary sources seem
> to be citing other sources that may not be primary. Does anyone
> know the real story here?
Yes: the real story is that this is a controversial issue with data
that can be spun in different ways depending on the biases of the
writer. A good way to start thinking about it is to spell out what
does and doesn't qualify as addiction (as you've done above, with your
reference to craving). For me, the distinction is between adaptive
and maladaptive patterns of use--i.e. is the drug mostly improving
the patient's life or mostly disrupting it?
The studies I've seen suggest that the latter is more likelyh to occur
chronic-pain patients with preexisting psychiatric comorbidity
(histories of depression, personality disorders, or, of course,
substance-use disorders) than in other chronic-pain patients.
--David Epstein
[EMAIL PROTECTED]
