The use of opioids in the treatment of chronic pain is very controversial. Possible addiction is one of the main reasons for this. Is the relief of chronic pain worth the potential for addiction? The consensus is yes. The fact is, most patients treated for chronic pain by a health professional qualified to do so will not become addicted to their opioid medications.
Addiction is Not the Same as Dependence
Anyone who takes opioid medication for any length of time, say, more than a few weeks, will become physically dependent upon their medication. This is a consequence of the actions of opioids on the body. They cause physical changes to take place in the brain which result in a physical dependence. This is not the same as addiction, which is generally defined as compulsive, uncontrollable use of a substance even when the negative consequences are obvious. Addicted patients often increase their use of medication without their physician’s knowledge or approval, which only makes their addiction even worse. They hide their drug use from friends, family, and employers. They become devious.
In contrast, those taking opioids as directed by their physicians rarely experience addiction. They are simply taking a drug, under medical supervision, that they need to control their chronic pain. There is no emotional dependence on the drug, no compulsion to use it beyond what is needed for pain control, and the patient remains in full compliance, taking the drug only as directed.
- An addicted patient will often run out of medication early
- An addicted patient will show signs of drug-seeking behavior, such as repeated requests for more pills and escalating doses when such is not medically indicated
- Those addicted are likely to withdraw from friends and family as the drug takes over more and more of their lives
In contrast, a patient who is merely physically dependent, which is not their fault anyway, continues to live their lives normally. Their basic behavior doesn’t change and they feel no compulsion to take more and more medication. They just enjoy the relief and quality of life provided by responsible use of opioid medications.
For most people, the risk of true addiction to prescription opioids is low. In fact, the negative effects and stress of living in constant, untreated pain are more of a real concern than addiction.
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