Opioid dependence [Neurosurgery Wiki]

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====== Opioid dependence ======

see also [[Opioid tolerance]]
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Although the prevalence of opioid dependence among European adults is low and varies considerably between countries, it is associated with a disproportionate amount of drug-related harm that includes infectious diseases and other health problems, mortality, unemployment, crime, homelessness and social exclusion. Heroin use remains a major concern but in many European countries the use of synthetic opioids has also been growing and in a few countries now predominates.
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Opioids were understood as being addictive with long-term use promoting a downward spiral of tolerance and withdrawal driving the pain, leading to continued prescription. Long-term opioid therapy could be justified for patients who improved in function, and who were perceived as [[trustworthy]]. Inadequate follow-up of patients, poor training in pain management and addiction medicine, personal attitudes and beliefs about opioids, a perceived professional obligation to treat patients with pain, and lack of collegial support, were factors understood to promote clinically unindicated long-term [[opioid]] [[therapy]]
((Ljungvall H, Öster C, Katila L, Åsenlöf P. "Opioids are opioids" - A phenomenographic analyses of physicians' understanding of what makes the initial prescription of opioids become long-term opioid therapy. Scand J Pain. 2022 Feb 17. doi: 10.1515/sjpain-2021-0171. Epub ahead of print. PMID: 35172418.)).