Opioids are addictive or cause dependency issues only?
When I see reports in the media about the problems associated with opioid prescriptions I get a little concerned with the association put alongside the issues that patients invariably become addicted to them.
The question Why can’t painkillers be both safe and effective? here also mentions the "addictive and deadly" nature of opioids.
When looking at the difference between dependence and addiction you can see how the 2 terms can be mis-attributed in some cases. When patients are taking opioids for pain relief, the need to take another dose after a while, and sometimes a higher dose after a while is not necessarily addiction.
For clarity after re-reading the question and the sources
With this question, I am not talking about methadone dispensing prescriptions for heroin addiction. I am talking about morphine for example, for severe and chronic pain relief.
Dependence is not the same as addiction and the word addiction is synymous with being a junkie so opiod users have been referred to as opioid junkies.
What I have been questioning, and the question still stands — Are opioids just dependency inducing or are they actually addictive to a majority of patients?
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There is no "yes" or "no" answer to your question as far as the use of both terms are concerned. Opioids have their sites of action in the brain, they suppress transmission of pain impulses in the brain. They were not manufactured in order to cause addition or dependency effects on the population. Since it's not possible, at least for now, to come up with medications that can suppress (pain) nerve impulses from certain parts of the body without certain other functions of the body being affected, we continue to make use of what we have. The mechanism of pain is perhaps much more complicated than we think today. People spent years before they could come up with those drugs and it makes sense to appreciate their works. Unfortunately, because those drugs have the tendency to stimulate the brain reward centre, they can cause dependency if not used with caution. Prolonged use of opioids can cause addition. For this reason, opioids are exclusively prescription drugs given under adequate monitoring by experts. We know it's not the best approach to treat pain but we just have to make use of what we have. Drugs are used when the benefits that one derives from using it outways the risk for not using it. This does not in any way refer the benefits that one derives from using them for recreational purposes but health. NSAIDs serve their purpose too, for treating mild to moderate musculoskeletal pain. The truth is, all drugs are potential poisns. Our body is highly complicated such that it's not easy to come up with that magic bullet that can locate pain in the body and remove it completely without causing other problems.
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