Doctors may have a greater tendency to undertreat, and patients may not be able to benefit from the treatments offered if they are actively abusing, particularly if the level of abuse is consistent with addiction. The doctor may want to avoid drugs that can be abused or very closely monitor those prescribed. It may be best to develop a contract or agreement between treating physician and patient, defining limits and acceptable behaviors. The doctor may strongly encourage non-drug therapies to complement any drugs that are prescribed. In one study that included 10,000 burn patients, no patients without a history of substance abuse became addicted to opioids administered for pain.
Tolerance means that a higher dose of a drug is required to maintain the same effect.
Tolerance to pain-relieving effects may not occur. If it does, it may be managed by gradually increasing a patient's dosage. Withdrawal can be prevented by gradually decreasing doses before completely stopping the medication. At Beth Israel Medical Center, our goal is to relieve pain safely and effectively. There are experts in pain within many fields of medicine.