Pain Medication: Tolerance, Dependence, and Addiction

tolerance, dependence, and addiction

Overuse and abuse of pain medications continue to be major issues in the US. People who are prescribed pain medication for injuries or illnesses can develop a tolerance, dependence, and addiction to those drugs. While medications can help you deal with pain, they are not a cure and are designed only to guide you through a specific recovery period. Tolerance, dependence, and addiction happen when the pain medication is misused or overused.

Overdoses

Taking too much of a prescription medication or an illegally obtained pain medication can lead to an overdose. In 2018, more than 67,300 people in the US died from drug-involved overdoses. Death rates from opioid-involved overdoses rose from 21,088 in 2010 to 46,802 in 2018. Death rates from prescription opioid overdoses rose from 3,442 in 1999 to 14,975 in 2018.

Understanding Tolerance, Dependence, and Addiction

There is a difference between tolerance, dependence, and addiction. Tolerance means that you continuously need higher doses of the pain medication to achieve the same effect as when you first began taking it. Your body develops a tolerance to the effects of the pain medication and doesn’t respond as well unless you continue to take more. This can also lead to an overdose.

When you are dependent on a drug, it means that if you don’t have it your body will go through withdrawal. You can experience physical and mental symptoms in withdrawal. Some of these symptoms may be mild – for example, if you decide to give up caffeine, you may experience some level of discomfort. However, others can have life threatening consequences, such as would be the case if you stop using a prescription pain reliever without professional supervision.

Many people who take a prescription medicine every day over a long period of time can become dependent; when they go off the drug, they need to do it gradually, to avoid withdrawal discomfort. Dependence typically happens when you use a drug long-term (six months or longer) to manage pain associated with a medical condition. Your body builds up a tolerance to the pain medication and then you become dependent on it to maintain the same level of effectiveness.

Addiction is a chronic, treatable disease. When you continue to use a pain medication and do not feel as though you can stop despite any negative consequences you may be facing, you have an addiction. You can be dependent or have a tolerance for a drug and not necessarily be addicted.

Addiction can have devastating, life-long consequences if not properly treated. Also known as a substance use disorder, addiction results in compulsive behaviors as well as an inability to control the use of the pain medication. Although addiction and dependence are different, when you are addicted to opioids, you are also typically dependent on them.

Addictive Pain Medications

According to Dr. Karsten Kueppenbender, an addiction psychiatrist at Harvard-affiliated McLean Hospital, “ninety-seven percent of patients don’t have a problem with opioids.” However, there are pain medications that can lead to tolerance, dependence, and addiction.

Opioids decrease the perception of pain and create a feeling of euphoria for some people, especially those who take the pain medication even though they are not actually in pain. Opioids are typically used for the short term, to treat severe pain following surgery. They may also be used for some long-term pain, such as pain related to cancer and terminal illness.

Opioids are a family of drugs that include:

  • Codeine
  • Fentanyl (including brand name Duragesic)
  • Oxycodone (including brand name OxyContin, Percocet, Percodan, Tylox, and Roxicet)
  • Morphine (including brand name MS Contin)
  • Meperidine (including brand name Demerol)
  • Hydrocodone (including brand name Vicodin and Lortab)
  • Hydromorphone (including brand name Dilaudid)

At Risk for Addiction

Even though some people can safely take pain medications that are properly prescribed by their physician without developing a tolerance, dependence, or addiction, there are factors that can predict your vulnerability to becoming addicted to pain medication, including:

  • Family history of problem substance use
  • Misuse of other substances
  • Other risky behaviors (such as problem gambling)
  • Past history of problem substance use

Additionally, undiagnosed or untreated mental health issues, such as depression, can predict an eventual reliance on substances for self-medicating tendencies that, in turn, only make the issue worse.

Contact PACE for Comprehensive Addiction Treatment

At PACE Recovery, we’ve helped hundreds of men enter into a life of recovery from opiate addiction through a combination of traditional and alternative therapeutic methods. If you are in the downward spiral of a pain medication addiction, contact PACE today to begin your life-changing journey. You can reach our highly trained staff at any time by calling 800-526-1851 to learn more about our programs, admission, insurances accepted, and availability.