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Abstract

Aberrant behaviors towards opioids Pain, whether related or not to a cancer diagnosis, can be addressed by multiple medications where the opioids are considered to represent the gold standard approach in the management of cancer and cancer treatment-associated pain. But the same opioids could cause euphoria by stimulating the brain reward system, particularly the mesolimbic dopaminergic circuits, that could lead to various aberrant behaviors towards the opioids. The aberrant behaviors should be of significant concern to prescribing physicians especially in the context of the opioid crisis that we are currently experiencing in the United States. Therefore, it is imperative for clinicians to detect and monitor these behaviors while striving to alleviate the suffering of their patients in pain. Concurrently, there is increased need to educate the opioid prescribers to understand certain aberrant behaviors to avoid mislabeling of those patients as drug addicts when in reality they are not and also to avoid increasing their already heightened psychosocial distress. This presentation will review the definitions for various substance use disorders with a particular emphasis on the addiction, pseudoaddiction, and chemical coping, behaviors that are intertwined yet differs based on the patient鈥檚 ultimate goal that is euphoria for addiction, relieving non-pain symptoms for chemical coping and nothing else but pain relief for pseudoaddiction.

Biography

Sorin Buga MD is an Associate Clinical Professor in the Department of Supportive Care Medicine at City of Hope, Duarte, California. He is board certified in internal medicine and hospice and palliative medicine and a fellow of the American College of Physicians and of the American Academy of Hospice and Palliative Medicine. He completed his fellowship in palliative medicine at H. Lee Moffitt Cancer Center in Tampa, Florida. He is the City of Hope’s representative on the NCCN Adult Cancer Pain Panel and an active member of the American Academy of Integrative Pain Management, the American Academy of Hospice and Palliative Medicine, the International Association for Hospice and Palliative Care and International Association for the Study of Pain. He has published in the peer review literature and is often invited to speak at scientific meetings.

E-mail: sbuga@coh.org