Instead of treating pain patients, doctors have now been saddled with added responsibility of being a policeman for addiction prone patients. Part of the problem stems from fact that opioids only reduce pain on average by 1/10. Add- ons like cymbalta, pregabalin and gabapentin do little to help chronic back pain and sciatica. Despite some “raves” about marijuana, other studies have found help more marginal. So the non-interventional doctors, who may not even know what a quadratus lumborum is, might be tempted to push opioids beyond what is helpful.
I offer tongue – in -cheek advice on finding the addiction prone patient.
Arch Oral Biol. 2019 Jan 7;99:66-72. doi: 10.1016/j.archoralbio.2019.01.004.
[Epub ahead of print]
Mental nerve injury induces novelty seeking behaviour leading to increasing ethanol intake in Wistar rats.
Pérez-Martínez IO et al
Rats, previously exposed to alcohol, will take up excessive alcohol consumption after chin nerve (mental nerve) damage (they insist wasn’t that bad). They define this as “novelty seeking” though I’m not sure if this was based on any interviews.
So rooting out addicts might be easier if you:
- offer the some cheese and see if it a hit; I’m told they really like Cheetos too.
- do they like to chew on things?
- do they have a mustache which is wriggled back and forth
- grinds his teeth back and forth
- do eye bulge out when they are excited?
- notice if they take their balled up hands and rub their face and other grooming behaviours
- see if the seem shifty and move eyes back and forth
- ask them if they have ever squealed on their friends or acted as an informer
- prefer dark secluded areas
- like to do novel things – like hang around new objects.
With this extra information, you can rout them out, and proudly proclaim that you smell a dirty rat. It doesn’t matter how much pain they have – they can just go back to whatever hole they came from…
Comment – having said that, even rats can become alcoholics from nerve damage so addictive behavior might be just natural… As for the novelty seeking ie – risk prone – they have recently found there is more than 100 genetic variants on that disorder:
Linnér, Richard Karlsson, et al.
Genome-wide association analyses of risk tolerance and risky behaviors in over 1 million individuals identify hundreds of loci and shared genetic influences.
Nature Genetics (2019): 1.
so lots of that out there