Brady says that high doses of Dilaudid were necessary to alleviate his patient's pain. The board's members saw it differently. Brady's partners are not alone. But fear of investigation is only one reason that physicians underprescribe narcotic drugs for pain, says June Dahl, professor of pharmacology at the University of Wisconsin Medical School in Madison. Doctors also have an irrational fear of patients becoming addicted to or tolerant of narcotics, she says.
Addiction describes the compulsive craving for a drug's psychoactive effects.
People in pain rarely experience euphoria when taking opioids. The belief that patients develop tolerance to opioids, so that the drug eventually fails to provide any pain relief, is also misguided, pain specialists say. That's just bad practice, says Foley. Clinical studies show that patients may stabilize on the same dose for many months. Moreover, she says, when a patient fails to stabilize, the physician can safely control the pain by gradually increasing the dose of opioids often to levels that would kill a person who had not previously taken opioids.