Pain, Addiction, Depression (PAD): Assessment of Pain and Addiction, the Neurobiology of Pain

Abstract

Medicine requires observation to develop a diagnostic conclusion. Trending from the traditional concept of 'stand by your diagnosis,' physicians and providers are finding themselves much better suited to maintain a large differential diagnosis, and keep that differential diagnosis dynamic and fluid. We cannot see, touch, feel, or measure pain, and observation many times verifies reality. As pain is a subject of interpretation and a very personal experience, nowhere else in medicine will we be challenged with the assumption that what the patient is telling us is cortect, and we have little opportunity lo follow the timeline, or 'the story,' lo a true point of validation. In other words, many times pain is just going lo have to be assumed lo be present, and the patient is telling you the correct information that the clinician needs to have to treat them effectively, in a safe and controlled environment. When controlled substances are used, however, the assumption that pain is present has to be weighed against the risk/reward benefit of a chosen therapy. We hope that that risk/ reward benefit remains in both the provider's favor, as well as the patient's, but as is often the case, there is no perfect world. More often, the provider of care and the patient experience peaks and valleys of success and frustration. (PsycInfo Database Record (c) 2020 APA, all rights reserved)