8 Facts and Myths About Opioid Pain Medication and Addiction
Opioids were involved in 47,600 overdose deaths in 2017 and 46,802 deaths in 2018. In 2020, overdose deaths increased significantly to 68,630.
Suffice to say, we are certainly in the midst of an opioid epidemic. As such, it’s imperative that you are informed about the facts and myths regarding opioid medication so that if prescribed, you can use this medication safely. And, more importantly, seek treatment if you need help with addiction.
Myth # 1: Opioid addiction is just a psychological disorder and people who are dependent simply need better willpower.
“It’s important to define opioid addiction carefully because the stigma is so strong,” says Richard Schottenfeld, MD, Senior Research Scientist; Affiliated Faculty, Yale Institute for Global Health. “Someone who is prescribed opioid medications for pain for prolonged periods may develop tolerance, which means they need a higher dose to get pain relief.” When they stop taking the medication, they may experience withdrawal symptoms. However, this is not considered opioid addiction.
“Opioid addiction, or technically ‘opioid use disorder,’ is defined as loss of control overuse of opioids,” Dr. Schottenfeld explains. An individual who continues to take opioids despite negative consequences or who is unable to stop despite wanting to do so despite detrimental consequences. There is also a possibility that this person is obsessively hooked on opioids, obtains opioids, or craves opioids. As well as developing tolerance or experiencing withdrawal, these patients may also be diagnosed with opioid use disorders.
It's thought by some people that opioid addictions are simply psychological, or that addicted people are weak-willed and incapable of quitting. However, the issue is more complex.
“Long-time use of opioids in an addictive way actually alters brain functioning,” he adds. “It causes chronic and lasting changes in the brain reward system, causing the person to feel less motivation and get less pleasure from other, naturally occurring rewards. Opioids become the primary reward and the primary focus of the person’s life, and they need more of it to activate the reward system.”
Myth # 2: Prescription opioids are less addictive.
People believe that prescription opioids don't cause as much harm or are less likely to cause death because of their legitimate medical use, notes Zawn Villines for WebMD. CDC statistics suggest that prescription opioids were the driving force behind the first wave of opioid addiction, which began in the 1990s.
In spite of being in the third wave of the opioid epidemic and CDC data showing illicit fentanyl is an important factor in overdose deaths, it's important to note that both prescription and illicit opioids can still be dangerous, Villines adds. Since 1999, overdose deaths involving prescription opioids have increased significantly, according to the
National Institute on Drug Abuse (NIDA).
Since a small percentage of people who misuse prescription opioids escalate to illicit heroin use, opioid abuse can also contribute to heroin addiction. NIDA suggests the lower price of heroin might be contributing to this trend.
Myth #3: The more you take, the better the effects.
The truth is, more is not always better. As people become accustomed to pain medicine, their tolerance increases. When you take too much pain medication, tolerance occurs sooner, which means your chronic pain may actually worsen.
Myth # 4: Medication for opioid addiction is harmful.
As an opioid, methadone has the ability to help treat addiction by easing withdrawal symptoms and enabling a person to gradually wean themselves off the opioid they are abusing. Food and Drug Administration (FDA) approved methadone for treatment of opioid use disorder, however, detractors contend that it is just another drug substitute.
Methadone and other FDA-approved medications for addiction treatment can make a significant contribution to addiction recovery when used under careful and accredited medical care. The use of medication-assisted treatment is not a drug substitution program, but an evidence-based treatment.
“Medications can play an important role in treatment by aiding in managing withdrawal symptoms, preventing relapse, and treating co-occurring disorders such as anxiety and depression, which sometimes contribute to the person’s addiction,” Leslia Bashioum, MS, LPC, an Addiction Counselor, told WebMD Connect to Care. “The best treatment programs will provide a combination of therapy and medication treatment to meet the needs of the individual.”
Myth # 5: If you take opioid pain medications for a valid reason, you can't get addicted.
The reality is that opioid pain medication is highly addictive. Anyone can become dependent on these medications, especially if they are taken over an extended period of time.
It is important to only take these medications as prescribed in order to avoid the risk of becoming addicted to them.
Myth # 6: Those who take opioids will become addicted.
Addiction risks vary greatly from person to person. This is why your doctor may ask you about your risk factors: a family history of addiction, a history of drug and alcohol abuse, or signs of psychosis.
Myth # 7: Opioids have no long-term side effects.
In addition to addiction, long-term opioid use carries other risks. It has been shown that these drugs can affect the way your hormones work in your body, which may affect your mental state, libido, and even osteoporosis risk. It is also possible for opioid medications to cause chronic constipation, which may lead to health problems such as bowel obstructions.
Myth # 8: It’s ok if we call people with opioid use disorder “addicts,” “users,” or “junkies.”
“The words we use to describe addiction and people with addiction are important,” states Jeanette Tetrault, MD, FACP, FASAM, Professor of Medicine and Public Health, Vice-Chair for Education for the Section of General Internal Medicine, Associate Director for the Program in Addiction Medicine, and Program Director for Addiction Medicine Fellowship at Yale School of Medicine.
“Negative terms such as ‘addict’, ‘user’, ‘junkie’, and phrases such as ‘needs to get clean’ contribute to stigma against people with opioid use disorder and create barriers to accessing effective treatment,” she states. Ultimately, this can lead to overdose. “When we talk about people with diabetes, we don’t talk about them being ‘dirty,’ we talk about their sugars.” Likewise, we should look at measurable changes in health for individuals struggling with opioid addiction.
“Studies have shown that people who were referred to as ‘substance users’ were more likely to be considered a threat or be responsible for their condition, whereas people who were referred to as having ‘substance use disorder’ were more likely to be seen as needing help,” Dr. Tetrault adds. “This is a really key component to getting people into treatment and stemming the opioid crisis.” People are not defined by their diseases. The opioid crisis has to be considered from this perspective, both by doctors, media, and the general public.