This is not addiction, and is not itself a substantial risk in clinical practice, because any adverse effects can be prevented by tapering the drug before discontinuation. Surveys of postoperative or burn patients indicate that less than 0.5 percent of patients with no prior history of substance abuse will develop problems after therapeutic use. Therefore, the risk of addiction should not be used to justify limited administration of the narcotic in the treatment of acute pain. The MEAC varies at least five-fold among patients. The physician relies upon the patient's report on the quality of the pain.
Pain is always subjective.
However, there are two reasons why PRN dosing regimens for acute pain may fail. First, patients usually expect pain relief to be delivered immediately upon request. PRN dosing can frequently contribute to a failure in this process. This occurs because either the patient waits too long to request more pain medication or, the staff cannot immediately administer the drug. Drugs used in the treatment of acute pain must be viewed as agents that need to be titrated on a frequent basis rather than being administered on a set dosing regimen determined by the average patient.