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From: anderson@uwmacc.UUCP (Jess Anderson)
Newsgroups: sci.med
Subject: Re: Aspirin vs. Codeine
Message-ID: <376@uwmacc.UUCP>
Date: Sun, 19-Oct-86 21:01:56 EDT
Article-I.D.: uwmacc.376
Posted: Sun Oct 19 21:01:56 1986
Date-Received: Mon, 20-Oct-86 21:13:53 EDT
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> All well and good, Jess, but there *is* a record of doctors underprescribing
> opiate analgesics when they would be most effective for pain, because of an
> inappropriate fear of addiction. 
  [...]
> The fact is that physical
> addiction and psychological habituation practically never occurs when 
> opiates are used for short periods of time for acute pain, especially
> with a drug like codeine which is rarely a primary drug of abuse.  
  [...]
> Chronic pain, such as lower back pain, or chronic conditions, such as
> migraine, are a different matter and the risk of habituation needs to
> be weighed against the patient's ability to receive relief from other
> conventional therapies.
> Steve Dyer

Thanks for reminding me of the need for *some* precision. I should have
made the acute/chronic distinction myself at the time. Interestingly,
the Vietnam War vet case would fall into both categories, because he
had a lot of opiate in the field hospital for the battle injuries, then
several surgeries in the next few days in his next hospital, then came
a really long period of surgeries/recoveries/more surgeries. He doesn't
talk about his drug reactions except in the first mind-boggling period,
presumably the most acute phase, but it's hardly conceivable that he
would not have developed a dependency on his analgesics as the chronic
phase followed. You're probably right, too, that people in the acute
circumstance may be undermedicated. My only first-hand experience (glad
to say) was a skiing accident (four fractures in the foot, ouch), and
I got off the codeine in about 3 days, switching to aspirin, because I
wanted my gut to work better (self likes food :-).
-- 
==ARPA:====================anderson@unix.macc.wisc.edu===Jess Anderson======
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