Although the conclusion that iatrogenic addiction and abuse are rare, still this appears to be inconsistent with the attitudes held by many healthcare providers and patients. Fear of addiction is commonplace. Consequently, there is evidence that overconcern about addiction adversely influences prescription practices.

The negative effects on patient care produced by an inaccurate estimate of addiction liability are most clearly documented in pain management— inadequate treatment with opioid drugs results in an unnecessarily high prevalence of unrelieved acute pain, especially cancer pain. Concerns about addiction are among the salient factors that contribute to undertreatment (Portenoy, 1995).

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