Cover

Chronic Pain and Addiction

Editor(s): Clark M.R. (Baltimore, Md.) 
Treisman G.J. (Baltimore, Md.) 
Table of Contents
Vol. 30, 2011
Section title: Paper
Clark MR, Treisman GJ (eds): Chronic Pain and Addiction. Adv Psychosom Med. Basel, Karger, 2011, vol 30, pp 8–21
(DOI:10.1159/000324063)

A Behaviorist Perspective

Treisman G.J. · Clark M.R.
Departments of aPsychiatry and Behavioral Sciences and bMedicine, The Johns Hopkins University School of Medicine, and cAIDS Psychiatry Service and dChronic Pain Treatment Program, The Johns Hopkins Medical Institutions, Baltimore, Md., USA

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 4/19/2011
Cover Date: 2011

Number of Print Pages: 14
Number of Figures: 1
Number of Tables: 4

ISBN: 978-3-8055-9725-8 (Print)
eISBN: 978-3-8055-9726-5 (Online)

Abstract

Chronic pain is a sensory experience that produces suffering and functional impairment and is the result of both sensory input as well as secondary adaptation of the nervous system. The sensitization of the nervous system to pain is influenced by physical activity (or inactivity) and medication exposure. Medication taking and physical activity are behaviors that are increased or decreased by positive and negative reinforcement. Patients often have comorbid psychiatric conditions at presentation, including addictions, mood disorders, personality vulnerabilities and life circumstances that amplify their disability and impede their recovery. Behavioral conditioning contributes to chronic pain disorders in the form of both classical (Pavlov) and operant (Skinner) conditioning that increases the experience of pain, the liability to ongoing injury, the central amplification of pain, the use of reinforcing medications such as opiates and benzodiazepines, and behaviors associated with disability. The term ‘abnormal illness behavior’ has been used to describe behaviors that are associated with illness but are not explained physiologically. Behavioral conditioning often amplifies these abnormal behaviors in patients with chronic pain. Addiction can also be seen as a behavior that is reinforced and conditioned. The same factors that amplify abnormal illness behaviors also increase the liability to addiction. Psychiatric comorbidities also complicate and amplify abnormal illness behaviors and addictive behaviors and further contribute to the disability of chronic pain patients. Model interventions that reinforce healthy behaviors and extinguish illness behaviors are effective in patients with addictions and chronic pain. Maladaptive behaviors including addictive behaviors can be used as targets for classical and operant conditioning techniques, and these techniques are demonstrably effective in patients with chronic pain and addictions.


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 4/19/2011
Cover Date: 2011

Number of Print Pages: 14
Number of Figures: 1
Number of Tables: 4

ISBN: 978-3-8055-9725-8 (Print)
eISBN: 978-3-8055-9726-5 (Online)


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Fordyce WE Fowler RS DeLateur B: An application of behavior modification technique to a problem of chronic pain. Behav Res Ther 1968; 6: 105-107
  2. Pilowsky I: Abnormal illness behaviour. Br J Med Psychol 1969; 42: 347-351
  3. Roscoe JA Morrow GR Aapro MS Molassiotis A Olver I: Anticipatory nausea and vomiting. Support Care Cancer 2010, E-pub ahead of print
  4. Poulos CX Hinson RE Siegel S: The role of Pavlovian processes in drug tolerance and dependence: implications for treatment. Addict Behav 1981; 6: 205-211
  5. Skinner BF: The operant side of behavior therapy. J Behav Ther Exp Psychiatry 1988; 19: 171-179
  6. Turk DC Okifuji A: What factors affect physicians’ decisions to prescribe opioids for chronic non-cancer pain patients?. Clin J Pain 1997; 13: 330-336
  7. Bekhit MH: Opioid-induced hyperalgesia and tolerance. Am J Ther 2010; 17: 498-510
  8. McHugh PR Slavney PR: The Perspectives of Psychiatry. 2 Baltimore, JHU, 1998;
  9. Schuckit MA: An overview of genetic influences in alcoholism. J Subst Abuse Treat 2009; 36: S5-S14