Pain requires continuous reassessment. He is president elect of the American Academy of Hospice and Palliative Medicine. Many physicians are reluctant to prescribe opioids for the treatment of pain in their elderly patients for fear of addicting them to the drug, or because they rely on an assessment of physical functioning rather than asking the patient if they are getting symptom relief. As regards addiction, there are three major issues involved in the use of opioids. The first, tolerance, requires increasing the dose to maintain analgesia.
Tolerance is a receptor phenomenon.
In fact, some data suggest that maintenance on opioids for a long period of time leads to an increased sensitivity to pain, thus requiring more opioids. This happens as part of the physiology of using these drugs. This is not addiction. Physical dependence occurs during opioid therapy as a normal response to therapy. No order for opioids is intiated.