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Pain Management

Abdominal Pain and Diabetes

11/16/2007

Question:

My husband has had bouts of abdominal pain for 8 years. Initially a bout every six months and then, slowly becoming more frequent, now he has it almost every morning. It varies in intensity - sometimes it will go away with 1 Percocet and other times he needs to be treated in hospital er with intravenous Dilaudid or Demeral. if its really bad he has been admitted and treated with iv narcotic every 3-4 hours for several days. some doctors will not treat him at all because they believe he is a drug addict or else they say he will become one if they give it to him. if his pain doesn't subside he has to return to er again, sometimes 3 times to get a doctor that will help. my husband has never craved or desired medication when he is not in pain but some doctors insist that he is addicted and his pain is actually withdrawal pain! He wants to keep out of er if he can. hes been on Oxycontin, Fentanyl patch, and methadone. only the patch helped and it became ineffective after some months. now the doctor is trying injection Dialuad 10mg/ml once a day. my question is does regular use always cause drugs to become ineffective? is it possible for someone to be dependent on it without becoming addicted? if not when he becomes addicted what will happen? will he just want more? will he get withdrawal pain on top of his regular pain?

Answer:

Of what I was able to collect from your description of your husband, he has abdominal pain of unknown origin and now requires daily opioids to control his pain with frequent visits to the hospital and the ER.

All what you said could happen-- he could be dependent and not addicted, or he could be both.

He needs to be seen and treated accordingly to the pathology (reason) of his disease.

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Response by:

Hammam  Akbik, MD, FIPP Hammam Akbik, MD, FIPP
Formerly, Assistant Professor of Anesthesia
College of Medicine
University of Cincinnati