[Drug dependence in therapy of chronic pain].

The use of drugs in pain therapy is characterized by the fear of addiction. As a result strong analgesics are underused. To compensate the missing analgesic effect the additional use of psychotropic drugs is common. There is still little knowledge that just this therapeutic strategy of underuse leads to iatrogenic addiction. To avoid misunderstandings and irritations in the discussion around addiction, there must be clearly distinguished between physical and psychological dependence. There is sufficient evidence that especially tranquilizers and mixed analgesics induce the development of psychological dependence. In pain therapy there is no indication for these substances. In contrast opioids can be used without causing psychological dependence, presuming the guidelines of drug therapy in chronic pain (e.g. WHO guidelines) are attended.