A woman came to my clinic for second opinion. She is diagnosed with recurrent breast cancer and she is experiencing moderate to severe cancer pain.
Her doctor already prescribed her morphine but she said that it only gave her relief for a few days but the pain has now returned.
I then asked her about the dose and frequency of her intake of morphine. She gave an answer which seemed quite adequate for her level of pain.
I became perplexed and made my reaction obvious to her. After a few more questions, I told her that I will be giving her additional medicines and I will increase her dose of morphine.
I Don’t Want to Get Hooked!
When I told her that I will increase the dose of morphine, she became concerned. She told me that she does not want to become addicted to the drug and said that she was actually adjusting her dose of morphine without telling her doctor when the pain diminished.
On further questioning, it became clear that the pain recurred when she started doing this.
The Myth of Addiction
Patients’ fear of becoming addicted to pain medicines is universal. This has largely been due to the anti-drug campaigns. Unfortunately, this has also brought a lot of harm to the patients who need pain relief.
Cancer patients think that opioids (Tramadol, Morphine, Oxycodone, Codeine) are drugs for addicts. These fears and misconceptions have overshadowed the true benefits that cancer patients who are in pain can get from them and have proven to be barriers in the effective management of cancer pain.
The opioids are front line drugs in the management of moderate to severe cancer pain. My experience in managing cancer patients has proven to me time and again that these fears about the opioids are irrational, unfounded and have caused needless pain and suffering.
Addiction is rarely a concern among cancer patients. Addiction has a very strong psychological component in that the patient thinks he needs the medicine in the absence of physical pain. This is not the case among cancer patients.
Cancer patients experience actual pain brought about by the presence of the tumor or as a consequence of treatment and therefore, these patients are seeking relief from real pain whereas drug addicts crave for the drug to get a “high” or to relieve anxiety and not really relief of physical pain.
Opioids are generally well-tolerated. Their side effects are minimal and can be easily managed. There is no justification for our cancer patients to suffer in pain.
For those who are interested to learn more about opioids or cancer pain, you may visit the following sites: