Severe opioid toxicity and somatization of psychosocial distress in a cancer patient with a background of chemical dependence |
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Authors: | P Lawlor P Walker E Bruera S Mitchell |
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Affiliation: | Palliative Care Program, Grey Nuns Community Health Centre, Edmonton, Alberta, Canada. |
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Abstract: | A case of severe opioid toxicity is described in a 52-year-old cancer patient. The patient presented with classical clinical features of central hyperexcitability associated with opioid toxicity: delirium, myoclonus, hallucinations, hyperalgesia, and a possible seizure. This patient had a background of severe psychosocial distress and somatization in addition to a history of benzodiazepine dependence and alcohol abuse. The occurrence of opioid toxicity in this patient highlights the risks of a unidimensional approach to cancer pain, which ignores the non-organic components of pain, such as psychosocial distress, which will not respond to escalating doses of opioid medication. |
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