Journal of psychoactive drugs
-
J Psychoactive Drugs · Apr 2012
ReviewChronic pain and addiction: challenging co-occurring disorders.
Chronic pain is commonly treated by prescribing an opioid medication. For those suffering from both chronic pain and substance dependence, barriers to adequate pain management increase. ⋯ Effective treatment may also be hampered by opioid-induced hyperalgesia, tolerance, physical dependence, "chemical coping," and diminished physical and emotional functioning. This article reviews current research trends, potential problems stemming from prescription opioid use, and suggestions for clinical practice.
-
J Psychoactive Drugs · Apr 2012
ReviewCannabis as an adjunct to or substitute for opiates in the treatment of chronic pain.
There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. ⋯ These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates. Despite a lack of regulatory oversight by federal governments in North America, community-based medical cannabis dispensaries have proven successful at supplying patients with a safe source of cannabis within an environment conducive to healing, and may be reducing the problematic use of pharmaceutical opiates and other potentially harmful substances in their communities.
-
J Psychoactive Drugs · Apr 2012
Case ReportsCraving dominates propofol addiction of an affected physician.
We report a case of severe dependence on propofol. For over a year, a 30-year-old male resident anesthesiologist injected 100-200 mg of propofol 20 to 40 times a day, reaching a daily total of up to 4 g. Compared to other withdrawal symptoms, craving for propofol was much more pronounced. ⋯ No other addiction was found in his history before he became dependent on propofol. This emphasizes that, especially with the patient's high injection rate, propofol has a powerful potential to be addictive. In most hospitals, the staff is put at risk by nonregulated dispensation and too easy access to this anesthetic drug.