What is an Iatrogenic Addiction?
A disorder that has spread like wildfire but is definitely not a scheduled stop for the patient; An iatrogenic condition is the pain pill addiction after an injury or surgery calls for pain management. No one knows whose body will hook onto certain chemicals until the situation has occurred.
Two major problems with treating chronic pain with opiates are addiction/dependence and side effects. Treating prescription medication addiction is not as simple as a drug and alcohol detoxification or rehabilitation program. Chronic pain patients present a greater challenge to doctors for several reasons including ongoing pain complaints, fear of activity and debilitation, high incidence of untreated psychological issues.
The definition of drug addiction and dependence are very controversial. It has developed over time and has been the subject of much debate in the development of the updated criteria for the Diagnostic and Statistical Manual of Mental Disorders, the bible of the psychology world. The American Society of Addiction Medicine defines addiction as “a primary, chronic, neurobiologic disease with genetic, psycho-social, and environmental factors influencing its development and manifestations.”
It is recognized by impaired control over drug use, compulsive use, continued use despite harm, and cravings. The term dependence is often used to denote a physiological dependence composed of tolerance and/or withdrawal symptoms.
Iatrogenic addiction refers to addiction that is caused by prescribed medications. The National Institute of Health’s MedLine Plus online dictionary defines iatrogenic as “induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures.” Unlike addiction to non-prescription drugs (e.g. alcohol, cocaine, heroin), addiction to prescription opiates requires a clinician to prescribe.
It is tempting to classify those with prescription medication problems as “addicts” and to believe all can be fixed by “detox.” This may be true for a small portion of these patients. Members of the medical community focusing on addiction and law enforcement are well aware of illicit drug addicts who find their way into the medical system specifically to acquire prescription drugs.
It is difficult to know exactly what percentage of chronic pain has driven patients into active addiction. Some have addictive habits, such as smoking and alcohol, while others have a history of addictions. However, others had no prior vulnerability and ended up with withdrawal and cravings when use was decreased or stopped.
It is time for the medical profession to treat pain as a multi-layered condition. That means most patients not only have biological factors, but also mental health issues which prolong disability and delay recovery. This makes treatment a more complicated endeavor than standard drug and alcohol detoxification and rehabilitation.
Detoxing from drugs is possibly one of the most uncomfortable things that a person will ever experience. It is like having the worst flu you ever experienced, mixed with a psychological torture. One minute you are hot, the next you are cold. Every muscle in your body screams out begging for the drug.
It is clear to see why many active addicts are afraid to stop using. Besides the physical and mental distress that one experiences when going through detox, there are certain drugs that symptoms can be life-threatening. Benzodiazepines are one example of a drug that you should never attempt to detox from alone. Drugs in this category are Xanax and Valium. The detox from these substances can cause seizures, which could result in death. When detoxing from a benzodiazepine, it is important that the proper medical personnel are present. Thousands of people attempt to detox and end up hospitalized or dead.
Years ago, physicians treated chronic pain patients with escalating doses of opiates despite dependence, addiction, the development of complications, and limited overall clinical and functional improvement. Today, most refuse to accept the liability of prescribing medication stronger than Tylenol 3. To break this pattern, a unique profile must be developed for the chronic pain patient and identify better tools for the management of both addiction and pain.