Streltzer J
Gen Hosp Psychiatry. 1980 Dec;2(4):262-6. doi: 10.1016/0163-8343(80)90078-x.
Despite the vast literature on drug dependence, little has been written about patients who become addicted while taking medically prescribed drugs for organic pathology. Observations from a psychiatric consultation-liaison service reveal that these patients are frequently middle-aged with no history of drug abuse before the onset of a chronic medical condition. Associated with their medical condition is a dependence on narcotics and/or psychotropic medications for such complaints as pain, headache, insomnia, and anxiety. Thea addiction may persist for years without acknowledgement by a patient, doctor, or family, although there is usually a progressive constriction of social and occupational functioning. The primary physician is highly valued by the patient; this manifest appreciation trends to facilitate the primary physician's continued prescription of large doses of addicting drugs. Treatment involving detoxification typically goes through a series of stages, each of which has characteristic hazards and pitfalls that can lead to failure of treatment.
尽管关于药物依赖的文献浩如烟海，但对于那些在因器质性病变而服用医嘱药物时成瘾的患者，却鲜有著述。来自精神科会诊-联络服务的观察结果显示，这些患者多为中年，在慢性疾病发作前无药物滥用史。与他们的疾病相关的是，因疼痛、头痛、失眠和焦虑等症状而对麻醉药品和/或精神药物产生依赖。这种成瘾可能会持续数年而未被患者、医生或家人察觉，尽管通常会出现社交和职业功能的逐渐受限。患者非常看重主治医生；这种明显的赞赏往往会促使主治医生继续开具大剂量成瘾药物的处方。涉及戒毒的治疗通常会经历一系列阶段，每个阶段都有独特的风险和陷阱，可能导致治疗失败。
