Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

How Depression Works

It is painful to have to assume the expenses associated with addiction arising after injury, and we are referring to addiction to narcotic analgesia. The expenses are considerable, but it is not illogical. Before anyone is referred to some facility in which narcotics are the standard of care, you need to know not only if the patient has a past history of addiction but is it prevalent in other family members. There are some individuals who have addicted first degree relatives but themselves have never abused alcohol or drugs. That is, _never_ until these drugs are prescribed for injury.

We also see patients who consider prescribed narcotics as quite different from alcohol and street drugs, and they fail to see a connection between past alcohol/drug problems and those prescribed for injury.

The core problem is that no one even asks the patient(s) about addiction in self or family. They prescribe narcotics presumably to _improve the quality of life_ of those with pain complaints. They then permit the patient_s subjective complaints to determine the level of narcotics prescribed. This is often done without a specific plan for tapering and discontinuing the drug.

Since this all occurs under authorized care, then the addiction is iatrogenic (arising as a result of care itself). The solution is prevention: be certain that all patients maintained are narcotics are queried as to the role of alcohol and drugs in themselves and family prior to treatment with such agents.

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