It can be challenging for medical professionals to distinguish between genuine undertreatment of pain and addiction. If those with pain don’t receive adequate opioid therapy, they may exhibit drug-seeking behaviors.
Healthcare providers could mistake this for addiction and classify as pseudoaddiction. Although certain people may be at higher risk of developing opioid addiction, it can potentially affect anyone.
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The signs of pseudoaddiction are similar to the symptoms of drug addiction, including:
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Differentiating between pseudoaddiction and addiction can be challenging as they exhibit similar symptoms. Some may display a craving for painkillers, which can stem from either a genuine need for pain relief or a desire to satisfy addiction.
To navigate this challenge, healthcare professionals look for specific signs. One red flag is a person’s persistent request for painkillers long after a surgical procedure or injury, which typically shouldn’t require prolonged medication.
In these situations, medical professionals use their clinical expertise and judgment. They evaluate your medical history, current condition, and risk factors for addiction to determine if your requests stem from unmanaged pain (pseudoaddiction) or addictive behaviors.
Yes, as opioids are highly addictive. If you keep using painkillers to treat pain, you can become dependent even long after your pain has subsided.
Around the world, millions of people have experienced or are currently dealing with opioid use disorder (OUD). 1 In the United States alone, there are over 3 million affected people, with more than half a million dependent on heroin. 1
Opioid-involved overdose deaths rose from 21,089 in 2010 to 47,600 in 2017 and remained steady through 2019. 2 However, there were 68,630 in 2020, which increased to 80,411 increase in 2021. 2
Pseudoaddiction treatment involves building trust between doctors and patients. People should believe their caregivers are committed to recognizing and treating their pain, reducing the need for unsafe methods.
Treatment for pseudoaddiction is similar to addiction management. The focus is on gradually reducing medication dependence and introducing alternative pain management methods.
In terms of alternative pain management:
Neglecting treatment for pseudoaddiction can lead to consequences:
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It’s essential to talk about the concept of pseudoaddiction because it plays a role in the opioid crisis. Between 21 and 29 percent of people who are prescribed opioids for chronic pain misuse them. 3
Opioid-related deaths are currently the deadliest drug epidemic in the U.S. In 2015, the Centers for Disease Control and Prevention reported an increase to 7.0 deaths per 100,000 people due to opioid analgesics. 4
Substance abuse also affects over 20 million people. 4 Substance use disorders involve opioids, methamphetamines, and alcohol.
Weissman and Haddox coined the term pseudoaddiction in 1989. It was a reference for those who had under-treated pain.
They described pseudoaddiction as an iatrogenic syndrome that’s an illness that medical treatment or intervention caused. In the case of pseudoaddiction, harm is due to withholding treatment or a lack of intervention.
Researchers first suggested that people with pseudoaddictions go through three phases:
There’s plenty of research on pseudoaddiction, and more is underway. However, there’s no evidence to support that a pseudoaddiction is clinically diagnosable. 5 There isn’t any evidence of objective signs or specific pseudoaddiction treatment plans.
It’s still hard to say whether someone’s dealing with undertreatment of their pain or opiate abuse. Either way, doctors need to take pseudoaddiction and addiction seriously.
Pseudoaddiction is a controversial concept that describes behavior that resembles addiction but stems from untreated pain. It’s crucial to acknowledge it as part of the opioid epidemic and find ways to treat it effectively.
By understanding pseudoaddiction, we can help prevent the worsening of chronic pain, health complications, and potential addiction. Despite its controversy, seek professional help if you or a loved one is struggling with untreated pain and potential pseudoaddiction.
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