There’s a fine line between addiction and dependence when it comes to powerful painkillers like opioids. Desperate for relief, patients with legitimate pain can exhibit some of the same behaviors as an addict.
So, how can you tell the difference?
First, it’s important to understand that dependence is purely the body’s physical need for a drug to feel well.
There’s nothing dangerous about this, and it’s very common for many medications, not just painkillers. For instance, a diabetic may be dependent on insulin, but they’re not addicted.
For those who are dependent on painkillers, suddenly stopping the medication will have negative consequences, including withdrawal symptoms like muscle twitching, vertigo, and nausea.
Dependence doesn’t cross over into addiction until it becomes a psychological compulsion to seek more drugs. These patients will do anything to get more drugs—including doctor shopping and using multiple pharmacies.
Here are some common signs to help you recognize an addicted patient:
- Presents with a poorly defined or difficult-to-diagnose injury
- Tells you which drugs usually work for them
- Is seeing you for the first time
- Appears friendly and talkative
- Seeks an unusually large number of pills with many refills
- Calls for refills before the prescription should have been completed with excuses about why they need them
- Appears to have an unusual depth of knowledge about drugs
- Refuses examinations, tests, or X-rays
- Has a vague history of previous physicians and work
- Becomes increasingly anxious and hostile when questioned
- Doesn’t keep appointments
Sources: Fall 2001 Counter Details, “Non-Medical Use of Prescription Drugs” by Thomas Hobbs, MD, PHD, FASAM; http://www.nationalpainfoundation.org/articles/134/addiction-and-chronic-pain.