Clinical note: PDF OnlyOpioid pseudoaddiction — an iatrogenic syndromeWeissman, David E.*,2,a; Haddox, David J.*,bAuthor Information aDivision of Hematology / Oncology, Medical College of Wisconsin, Milwaukee, WIU.S.A. bDepartments of Anesthesiology and Psychiatry, Medical College of Wisconsin, Milwaukee, WIU.S.A. *Correspondence to: David E. Weissman, M.D., Milwaukee County Medical Complex, 8700 W. Wisconsin Avenue, Milwaukee, WI 53226, U.S.A. 2Dr. Weissman is a recipient of an American Cancer Society Clinical Oncology Career Development Award. Submitted June 1, 1988; accepted November 16, 1988. The work was done under the auspices of the Cancer Pain Management Service of the Medical College of Wisconsin. Pain: March 1989 - Volume 36 - Issue 3 - p 363-366 doi: 10.1016/0304-3959(89)90097-3 Buy Metrics Abstract A case is presented of a 17-year-old with leukemia, pneumonia and chest-wall pain. Inadequate treatment of the patient's pain led to behavioral changes similar to those seen with idiopathic opioid psychologic dependence (addiction). The term pseudoaddiction is introduced to describe the iatrogenic syndrome of abnormal behavior developing as a direct consequence of inadequate pain management. The natural history of pseudoaddiction includes progression through 3 characteristic phases including: (1) inadequate prescription of analgesics to meet the primary pain stimulus, (2) escalation of analgesic demands by the patient associated with behavioral changes to convince others of the pain's severity, and (3) a crisis of mistrust between the patient and the health care team. Treatment strategies include establishing trust between the patient and the health care team and providing appropriate and timely analgesics to control the patient's level of pain. © Lippincott-Raven Publishers.