The estimated prevalence of addiction to any substance in pain patients is about 10 percent, yet most physicians who prescribe potent pain drugs have little training in addiction or confronting aberrant drug behavior. Even though substance abuse is evident in chronic pain patients, potential addiction risk does not outweigh the benefit of effective pain management. Optimal use of opioids, therefore, requires physicians to evaluate potential drug-abuse risks in their patients. But how?

Long-term, heavy cannabis use may be associated with structural abnormalities in areas of the brain known as the hippocampus and amygdala, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Conflicting evidence exists regarding the long-term effects of cannabis use, according to background information in the article. “Although growing literature suggests that long-term cannabis use is associated with a wide range of adverse health consequences, many people in the community, as well as cannabis users themselves, believe that cannabis is relatively harmless and should be legally available,” the authors write.