It's the patient's responsibility to find a doctor who knows how to screen for addiction.
(ISTOCKPHOTO)
The tricky part for pain patients, says David Fishbain, MD, a professor of psychiatry at the University of Miami, is finding a doctor who knows how to do the screening.
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Pain patients are often bounced from family doctors to specialists and back, with no one taking the time to monitor their ongoing use of the medication, or to “qualify” them for what the medical profession calls chronic opioid analgesic therapy (COAT)—the taking of narcotic painkillers for a long period of time.
That means it falls to patients to find health-care practitioners who are experienced in working with chronic pain patients, so that the physicians are comfortable deciding both when to prescribe narcotics and how their use can be safely monitored.
The top warning signs of addiction risk are, not surprisingly, a history of illicit drug use or alcohol abuse in the patient or his family. But smoking is also on Dr. Fishbain’s radar, because “any addiction is a potential risk factor for another addiction.” And there's a long list of factors that may be less predictive but still relevant, including depression and anxiety disorders, which means that doctors need to consider the patient's entire history and not just how he or she answers a few targeted questions.
