Chronic Nonmalignant Pain Treated with Long-Term Oral Narcotic Analgesics

AbstractFifty-nine patients maintained on oral narcotic analgesics for the chronic nonmalignant pain of physical illness were followed for an average of 36 months by five consultation psychiatrists (A.J.B., G.B.M., E.H.C., T.A.S., G.E.T.). The patients followed were originally referred by their primary physician for psychiatric consultation for complaints of pain and suffering. The opinion of the referring physician and consulting psychiatrist was that narcotics were the drugs of choice for the patient's pain and suffering associated with the medical condition. No patients were known abusers or addicts to narcotics on initial referral.By the end of the 36 months' average follow-up, 20 patients (34%) had complete relief from their pain, 41 patients (69%) developed some tolerance, and 33 patients (56%) abused narcotics. Significant (treatment-limiting) tolerance developed in 13 patients (22%), serious abuse was noted in 16 patients (27%), and narcotics addiction was diagnosed in 14 patients (24%). Efficacio...