What Are Aberrant Drug-Related Behaviors?
In 1994, Portenoy described a group of operational aberrant drug-related phenomenon that he felt characterized the definition of addiction as exemplified by its three aspects: 1) loss of control over drug use; 2) compulsive use; and 3) continued use despite harm. These behaviors are presented in Table 1 and can alert the physician to the possibility of addiction. Using a checklist for these behaviors, 388 patients with chronic pain maintained on opioids were monitored (Passik et al., 2002). The prevalence ranged from a high of 13.3% for unsanctioned dose escalation to a low of 1.1% for drug hoarding. It is interesting to note that the prevalence of behaviors that would clearly indicate addiction, such as injecting oral formulations and concurrent abuse of illicit drugs, was only at 1.5% and 1.9%, respectively. Passik et al. (2002) concluded that the incidence of aberrant drug-related behaviors was low. These behaviors do not necessarily represent addiction, but may be representative of
