Opioid Treatment for Chronic Back Pain and Its Association with Addiction
Authors: Bridget A. Martell
Journal: Annals of Internal Medicine (2007)

Letters4 September 2007Opioid Treatment for Chronic Back Pain and Its Association with AddictionBridget A. Martell, MD, MA, William C. Becker, MD, and David A. Fiellin, MDBridget A. Martell, MD, MAFrom Yale University School of Medicine, New Haven, CT 06520.Search for more papers by this author, William C. Becker, MDFrom Yale University School of Medicine, New Haven, CT 06520.Search for more papers by this author, and David A. Fiellin, MDFrom Yale University School of Medicine, New Haven, CT 06520.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-5-200709040-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Ms. Noble and Dr. Schoelles that it is unfortunate that there are not more high-quality studies of the abuse or addiction risk of prescribed opioids. We believe that we pointed out the concerning methodological limitations in our paper. We agree with Dr. DuPont and colleagues that, given our understanding of addictive processes and opioids, it is essential to evaluate pharmaceutical opioids for their effect on the brain's reward systems and their likelihood to induce syndromes that would result in abuse or addiction. Clinicians should know the risk potential of the medications that they prescribe. In ...References1. Prevalence and recent trends in misuse of prescription drugs. In: Colliver JD, Kroutil LA, Dai L, Gfroerer JC. Misuse of Prescription Drugs: Data from the 2002, 2003, and 2004 National Surveys on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2006. DHHS publication no. SMA 06-4192, Analytic Series A-28. Accessed at www.oas.samhsa.gov/prescription/Ch2.htm on 12 July 2007. Google Scholar2. de Wit H. Priming effects with drugs and other reinforcers. Exp Clin Psychopharmacol. 1996;4:5-10. CrossrefGoogle Scholar3. Shalev U, Grimm JW, Shaham Y. Neurobiology of relapse to heroin and cocaine seeking: a review. Pharmacol Rev. 2002;54:1-42. [PMID: 11870259] CrossrefMedlineGoogle Scholar4. Stewart J. Pathways to relapse: the neurobiology of drug- and stress-induced relapse to drug-taking. J Psychiatry Neurosci. 2000;25:125-36. [PMID: 10740986] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Bridget A. Martell, MD, MA; William C. Becker, MD; David A. Fiellin, MDAffiliations: From Yale University School of Medicine, New Haven, CT 06520.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Opioid Treatment for Chronic Back Pain: Prevalence, Efficacy, and Association with Addiction Bridget A. Martell , Patrick G. O'Connor , Robert D. Kerns , William C. Becker , Knashawn H. Morales , Thomas R. Kosten , and David A. Fiellin Opioid Treatment for Chronic Back Pain and Its Association with Addiction Meredith Noble and Karen Schoelles Opioid Treatment for Chronic Back Pain and Its Association with Addiction Robert L. DuPont , Noni A. Graham , and Mark S. Gold Metrics 4 September 2007Volume 147, Issue 5Page: 349-350KeywordsAlcoholsBehaviorBrainConflicts of interestDrugsLower back painOpioid addictionOpioidsSubstance abuse ePublished: 4 September 2007 Issue Published: 4 September 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...