Handbook for Mortals : Controlling Pain : Fear of addiction

Many people are worried about addiction to pain medicine. Unfortunately, as our society has battled illegal drug use, people have become discouraged from taking legal medications when they really need them. But you should not "just say no" to good pain relief. And you will not become an addict by taking your medicine as prescribed.

Addiction is a psychological disorder of drug craving and compulsive drug use when taking drugs is harmful to the user. Addiction is really very rare in people who take opioids for illness. It is not the same as taking medicine because you have pain. It is not the same as tolerance or physical dependence, either.

Tolerance means that increasing doses of an opioid are needed to maintain the effects of the medicine. In treating pain with opioids, tolerance is a useful feature. It allows most side effects to wear off a few days after a dose is increased.

Physical dependence means that the body becomes used to having an opioid present. Physical dependence happens to everyone who uses opioids for more than a few days, but all it means is that opioids should never be stopped suddenly. They should be weaned over a few days if they are going to be stopped. If they are stopped suddenly, you may have withdrawal - a very uncomfortable flu-like syndrome including muscle aches, nausea, diarrhea, and sometimes vomiting or even muscle spasms. If a person suddenly cannot take opioids by mouth, the weaning needs to be done by some other route (by rectal suppository or intravenous infusion, for example).

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Handbook for Mortals book cover Copyright © 1999, 2006 by Joanne Lynn. This extract from the Handbook for Mortals by Joanne Lynn, M.D. and Joan Harrold, M.D. is used with permission.
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