Pseudoaddiction and Misinterpretation of Symptoms

Defined in 1989 pseudo-addiction is a worrying concept that has the potential to severely disrupt people’s lives and cause great concerns, often meaning that healthcare providers do not administer adequate care for their patients.

What Is Pseudo-Addiction?

Pseudo-addiction occurs when a patient’s signs and symptoms of existing pain are misinterpreted by carers causing a failure in adequate pain relief provision.

Signs and symptoms of a person diagnosed with pseudo-addiction are usually associated with the behaviours displayed by drug addicts seeking to receive superfluous analgesia.

Typical behaviours include the constant request for pain relief, knowing exactly when pain relief is due or can be taken, even causing clock-watching and knowing in-depth information about different types of pain relief. These patients often moan, groan and overtly verbalise their pain in an effort to receive further pain relief. In the case of pseudo-addiction, the patient is actually experiencing high levels of pain, but due to their behaviours, staff are often reluctant to administer pain relief as they do not want to encourage drug use by what they believe to be an addict, often exacerbating the situation.

Another influencing factor for staff misinterpretation of the symptoms includes the pain not matching the diagnosis or because other patients with the same diagnosis manage their pain with the recommended pain relief.

Pseudo-addiction normally occurs in the presence of acute pain experienced with a chronic condition.

The exaggerated behaviours displayed by the patient are often due the person’s frustration and desperation to relieve their pain, combined with the problem of seeming to be not believed by the professionals.

Management of Pseudo-Addiction

As this condition has now been discovered, named and partly understood, healthcare professionals can now recognise this as a legitimate condition and can begin to address the issues surrounding it.

Staff must try and distinguish the difference in true pain and that which is exaggerated on purpose to gain pain relief. This is a very fine line, especially so if the person has a history of substance abuse or drug addiction. The decision, by the professional as to whether to risk under-treating a patient by being overly cautious, is not one to be made quickly, and requires research and careful thought.

Management includes re-assessing of the persons illness, diagnosis, existing treatment and pain schedule combined with a full medical and psychological history.

The information gained can help to remodel the treatment plan and pain therapies in association with approved evaluation procedures until both the healthcare provider and patient are satisfied with the result.

Healthcare providers must however, be aware that by redesigning the pain schedule may involve using higher strength drugs than is normally necessary for the condition thus resulting in the person actually becoming dependent on the substance, hence the need for frequent evaluation and re-assessments of the pain, lowering the dosages or changing the prescription when necessary.

Pseudo-addiction is a very complicated phenomena to describe and understand; a simple explanation is when pain is poorly treated as the person displays behaviours associated with substance addiction.

Many physicians now feel such fear of the legal issues surrounding medical practices, that many believe all pain complaints are genuine, and will treat as so.