Opioid Addiction Vs. Opioid Dependence

According to ClinCalc.com, over 40 million Acetaminophen; Hydrocodone Bitartrate prescriptions and over 21 million Tramadol Hydrochloride prescriptions were written in 2017. These medications are both forms of opioid pain relievers and they are only 2 of the many forms of opioids prescribed by physicians each year. These medications carry a number of side effects including the risk of developing dependence and addiction. There is a significant difference between an opioid addiction vs. an opioid dependence, but the line of crossing over from dependence to addiction is thin and often difficult to pinpoint.

What is Opioid Dependence?

Opioid dependence is when the human body requires continuous use of opioid medications in order to prevent the onset of physical withdrawal symptoms. Dependence develops over time as the actual brain composition changes in an effort to adapt to a continuous increase in the release of dopamine, a neurotransmitter. Usually, dependence happens due to long-term opioid use and increased doses consumed in an effort to achieve the same level of pain relief. An individual can experience physical dependence without developing an opioid use disorder, the medical term for addiction.

What is Opioid Addiction?

The DSM-V classifies addictions as a mild, moderate, or severe substance use disorder. Addiction is defined as “a brain disease that is manifested by compulsive substance use despite harmful consequence”. In essence, an addiction is when an individual continues to use drugs even when they face consequences such as health issues, job loss, relationship problems, and legal charges caused by drug use. Just as dependence can be present without addiction, addiction can develop without a dependence. However, in the event of addiction, the development of dependence is almost inevitable.

Dependence & It’s Significance with Addiction

Due to the nature of opioid drugs, if they are used over a long-period of time, a tolerance is developed. This means that even though the same dose is taken, the previous effects of the drug are no longer felt. In some cases, a physician may prescribe a higher dose, but some users simply take an extra dose on their own. Without a treatment plan that works towards getting the user off of the pain relievers, the tolerance will go up and up and they eventually develop a dependence. According to DrugAbuse.gov, between 21 to 29 percent of individuals prescribed opioids for chronic pain misuse them. This includes people who take a greater dose to feel pain relief without a doctor’s direction. Those individuals who continue to do so, even when they inevitably experience negative consequences, have crossed the line to addiction.

Opioid Dependence vs. Addiction Treatment

As opioid dependence and addiction are so closely connected, most individuals who struggle with opioids in any manner start treatment in a detox program. Detox facilities are ideal for the first days of recovery as they are equipped to address the potential physical and psychological symptoms of discontinuing opioid use. Those who are dependent on opioids, but not addicted, may complete treatment after detox. In reality, all users can benefit from a long-term individualized treatment plan. Those struggling with addiction should also enroll in an inpatient or outpatient treatment program that helps clients develop the skills and tools to maintain sobriety long term. 

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