Definition: A behavioral syndrome characterized by evidence of psychological dependence (craving), uncontrolled/compulsive drug use despite harmful side effects, and other drug-related aberrant behavior (e.g., altering prescriptions, manipulating health care providers, drug hoarding or sales, unsanctioned dose escalation).
Prevalence: Opioid addiction is as high as 50% in patients with chronic nonmalignant pain. 7.7% in patients with cancer related pain. (references 1).
The daily dose of opioids in abusing or addicted patients is typically larger, such patients often have coexisting psychiatric diseases (depression, anxiety, psychosis), and the known history of abuse may lead to tempered use of opioids by health care providers, which makes these patients particularly vulnerable to inadequate postoperative pain control.
Jette Højsted, Per Sjøgren Addiction to opioids in chronic pain patients: a literature review. Eur J Pain: 2007, 11(5);490-518