chapter  18
14 Pages

Persons Tolerant to or Dependent upon Opioids and Pain of Undocumented Etiology

Although management of pain may often present a problem to the physi­ cian not thoroughly familiar with analgesic agents, the problem is most severe in persons who already have a tolerance to narcotics or who are truly dependent. This large heterogenous population can be classified into four major categories: (1) persons currently dependent on physician-prescribed narcotics secondary to an underlying medical disorder; (2) persons depen­ dent on street narcotics without any underlying medical disorder preceding narcotic use, (3) persons currently dependent on methadone prescribed through a methadone maintenance program, and (4) persons with pain of undefined origin.