The patient is admitted for chronic pain.He states that meperidine (Demerol)used to help,but that he has been needing to use more and more drug and is getting less and less of an effect.This patient's plan of care will have to incorporate steps to deal with which of the following?

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Drug tolerance is defined as a state of adaptation in which exposure to a drug induces changes that result in diminution of one or more of the drug's effects over time.
Addiction is defined as a primary,chronic,neurobiological disease with genetic,psychosocial,and environmental factors that influence its development and manifestations.It is characterized by behaviors that include one or more of the following: impaired control over drug use,compulsive use,continued use despite harm,and craving.Pseudoaddiction is a term that describes patient behavior that may occur when pain is undertreated.Patients with unrelieved pain may focus on obtaining medications,may "clock watch," or otherwise may seem inappropriately "drug seeking." Even such behaviors as illicit drug use and deception can occur in the patient's efforts to obtain relief.Pseudoaddiction can be distinguished from true addiction in that behaviors resolve when pain is effectively treated.Physical dependence is a state of adaptation that often includes tolerance and is manifested by a drug class-specific withdrawal syndrome that can be produced by abrupt cessation,rapid dose reduction,decreased blood level of the drug,and/or administration of an antagonist.

The Patient Is Admitted for Chronic Pain