Adicción frente a seudoadicción

The widespread use of opioids, especially fast-acting fentanyl preparations for the treatment of cancer pain, has produced the development of aberrant behaviors during the chronic opioid therapy, and a resurgence of old myths about morphine addiction. Nowadays, new terms are used such as pseudoaddiction, pseudotolerance and chemical coping. In this article, we analyze the different concepts and behaviors that should lead clinicians to suspect these diagnoses, the factors associated with opioid misuse and the treatment recommendations for safe and efficient prescription. To prevent the development of addiction, pseudoaddiction and chemical coping in patients with cancer pain, a multidisciplinary approach is required for each of its factors (physical, psychological, social and spiritual), with special emphasis on the management of anxiety and depression.