Describes the intake by patients with cancer of opioids on a scale covering the range between normal nonaddictive opioid use for pain all the way to total addiction and its accompanying compulsive, destructive behavior. Most patients will fall somewhere between the two extremes, using their medications in non-prescribed ways to cope with their stress.
The relationship between addiction and chemical coping is briefly stated as: “All addicts are chemical copers, but not all chemical copers are addicts.”
Mild chemical copers may not experience any major adverse effects, whereas those approaching the addiction end of the spectrum are at risk for increased morbidity and mortality. The extent to which patients use their medications in a maladaptive way will determine their susceptibility to drug toxicity and harm.
Chemical coping and addiction should be distinguished from physical tolerance and withdrawal syndrome that occur when opioids are abruptly discontinued. Addiction is characterized by changes in brain structure and function that accompany chronic exposure to drugs of abuse.