Long-term opioid user needs pain specialist

Dear Annie: In a recent column, a reader stated his wife has a serious addiction to pain pills after years of being prescribed them, hasn't worked in those years, spends most of her time in bed, breaks into pill safes and begs for more pills. You told him that his wife has a severe opioid addiction. This is entirely possible. However, it is not clear from the letter that his wife's doctor has been consulted to diagnose addiction.

There are a number of other issues that might have her asking for more pain medicine. It is possible, for example, that she is desperate because her pain is inadequately controlled. This can result in behaviour that resembles addiction and is often called “pseudo-addiction.” If it is pseudo-addiction, this does not mean the reader should give his wife extra pills. It does mean that a doctor with experience in pain control needs to be consulted. It is possible, for example, that a different medicine may be more useful than more of her current one. However, that is not my call to make, or her family's, or yours. It is a pain specialist's job to make those decisions.

With long-term use of opioids, the body gets used to them. With tolerance, opioids get less effective at pain relief, so over time, more pain medicine is often needed, even if the pain is not growing.

A Pharmacy Student

Dear Pharmacy Student:

Thank you for your wellthought-out letter. Any type of drug addiction is serious and will always be taken seriously by a doctor, and a treatment plan should be put in place.

Dear Annie: I thought you were a little short to the customer who complained about his takeout.

Did you not notice that “Lost Customer in Wilmington” said he is mildly disabled? Did you not think his walk to and from the restaurant might have met his limit for the day? And how did he not give the server a chance to earn a tip? I hope he has learned from this to always check his order before leaving, but still, he had a right to expect that his meal would be adequate at least.

If he had left the meal in the bag and taken it back the next day, he probably would have been offered tonight's meal at no charge or his money refunded, as well as the chance to vent gently. Anyway, I feel he deserved a bit of sympathy. Been There

Dear Been There: Thank you for sharing your perspective. I am always for giving people the benefit of the doubt, even if it is over a disappointing dinner. Your point about being sympathetic to his disability is a good one, and I sincerely appreciate it.

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