Are opiates really addictive?

With all the recent discussion on gun control and mental health and those with some mental defect have done using guns .. is now the focus of the media and many bureaucrats.

We know that it is claimed that Nicotine is the most addictive drug that is readily available and used by man..

It is reported that 20% of our population at ,any given point in time, are borderline alcoholics..

It is presume that some 5% +/- of the population abuses some substance from various parts of the opium plant, bath salts, or just about any substances that can alter a person’s perception of reality.

I have dealt with chronic pain pts that have been on opiates for years and they don’t display any “drug seeking” characteristics. They will of course experience withdrawal symptoms if they abruptly cease taking their medication.. but.. look at the potential problem a person may experience if they abruptly stop their beta blocker… which I know of no one has stated is addictive.  Dependency is not the same thing as addiction and titrating a pt off of any of these drugs will avoid withdrawal and allow the pt to stop using the drug… if not otherwise medically necessary.

I have read statement by people that claimed that became addicted by taking “one dose”. As I age.. I have personally had acute episodes of pain for days.. as high as 7-8. I subscribe to the school of thought that chronic pain is often the result of poorly treated acute pain and the nerve path becomes engrained in “sensing pain” and it is never able to revert to a “normal state”

Given my specialty in pain management… our PCP is very flexible and trusting when I request a Rx for opiates.. I have also consulted with him on some of his chronic pain pts..  I have taken some sizable doses of opiates for a week or two at a time.. to optimize my pain management.. and hopefully prevent the nerve becoming engrained… so far it has worked… once the source of the pain is resolved… I stop the opiates.. usually fairly abruptly without consequences of side effects/withdrawal.

The question is… could as much as some 20%-25% of our population have some “mental defect” that predisposes them to “enjoy” the side effects of opiates like sedation and similar side effects…  to a point that they can’t resist continuing taking the meds and as tolerance develops  and  they seek a high level of side effects.. and once the time happens when they run out of the drug and they go into withdrawal..  They don’t seek – or know to seek – treatment for the withdrawal symptoms .. other than getting their hands on more of the drug.. to make the withdrawal symptoms go away… a rather viscous cycle… and they are labeled as a addict.

Is this “mental defect” a chemical imbalance in the brain.. or just a mis-wiring of some people’s brain… the inability to deal with certain stressors in their life.. and unable or unwilling to seek out professional help in dealing with their issues.

Our society has become more accepting of mental health issues over the past couple of decades in particular, but, IMO.. we have a long way to go… many in society have gotten past the point of telling a depressed person to “suck it up and get over it”

Could “mental health” be the underlying cause of what we call “addiction” and all these decades/centuries we have been blaming the drugs? Could our deep Puritanical roots prevent us from using logic .. instead of  our irrational emotions to look at this problem in our society?

Let the slings and arrows commence 🙂

4 Responses

  1. […] Young Gun posted this comment under my post of Are Opiates Really Addicting […]

  2. Some of the drugs I take to be normal are drugs others take to get high. Mental health, stress, and how you’re “wired” seem to have a lot to do with it.

  3. Any substance or activity that has a short term feeling of euphoria/fullfilment by the user can have a tendency towards causing full fledged addiction. There are the common ones we are taught to identify such as nicotine, alcohol, opiates, benzodiazepines (particularly short acting ones, ie Xanax), other sedatives, methamphetamine, cocaine , etc. As easily as a person can be addicted to a substance, they can also be addicted to an activity that brings them pleasure. There are shopaholics, workaholics, chronic masturbators, sex addicts, greed addicts, power addicts, internet addicts, food addicts, etc. The difference is not in the underlying causal mechanism, which I liken to being primarily in a state of unhappiness or dissatisfaction with your current state of being and wanting to escape; but instead it is defined as addiction based on society’s belief structure. To illustrate this point lets loosely define addiction as an act/substance which the addict compulsively engages in to the exclusion of other normal activities even though the addict is aware that their relationship with the act/substance is causing physical/emotional/mental harm to himself or others and they have an unwillingness or inability to stop. So lets say Steve is addicted to methamphetamine. Steve will eventually get caught using by the authorities and get sent to treatment (or god forbid prison), or overdose and die. On the other hand Tom is addicted to work and power, he works day and night for the corporation to the exclusion of everything else in his life. Tom eventually becomes CEO of the corporation and impresses his addiction upon his employees expecting total obiediance of his underlings to maximize profits even though his actions and expectations are destroying personal relationships, harming the environment, destroying mental/physical health of his employees, etc. the difference between Steve and Tom is that society acknowledges Steve’s addiction while denying that Tom has any problem at all. In fact it is likely that Tom will be given several rewards, huge compensation, and praise from most people even as he systematically destroys his life and his workers lives through his addiction. Addiction is a MENTAL state of being compounded by a physical craving for a substance. Modern medicine focuses almost exclusively on the physical aspects of addiction while focusing solely on abstinence as the only form of mental treatment. Well it’s no wonder why almost all addicts “use” again! The causal mechanism of unhappiness, unfulfillment, dissatisfaction and disequalibrium have not been addressed! What I believe we need to address is either:
    1) Acknowledging the blocked/negative emotions, feelings, and diet of the addict that have lead to the disequalibrium and tendency toward addiction.

    AND/OR

    2) Provide/teach another healthy activity (like yoga, meditation, etc.) that causes more long lasting fulfillment or joy than the destructive relationship with the act or substance so the addict chooses the less destructive activity by default.

    In conclusion, no substance or activity in itself is “addictive” to everybody. It depends upon how your brain is wired and the state of your mental/emotional well being. Also we need to broaden our scope of what we call addiction. I would think that most people have an addictive relationship with at least 1 activity or substance. Treatment should not focus solely on abstinence but should include psychotherapy to identify and come to terms with the negative thoughts/emotions that promote addiction. Also addicts should be given the tools to find a new pursuit that brings them even greater pleasure/joy!
    Thanks for reading
    Young Gun

  4. I subscribe the idea that some people are prone to addiction. It is really not the drug that is addicting, but the nature of the patient that makes them seek the drug and to take more and more of the drug. We all see these type of people. How many people did you see addicted to Darvon? The number I saw was miniscule. I don’t believe the drug had any addiction properties. Look at tramadol. It is a very moderate pain killer. I doubt that one tablet is any more powerful than Ibuprofen 200. But, some patients will seek after the tramadol and it appears will take large quantities at each dose. Is it the drug or the patient to blame? If it was not tramdol, then it would be something else….even large quantities of aspirin.

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