What Is Opiate Dependence?

Opiate dependence involves physical factors, including tolerance, that contribute to a physical need to take or continue taking pain killers. Dependence can be a result of a painful diseases or illness, and occurs with both self-administration of opiates and even under medical supervision.

Tolerance

• Tolerance plays a part in opiate dependence by increasing the physical need for larger opiate doses. The body and brain become tolerant to the effects of pain killers, and greater doses are needed to produce the same pain management or euphoric effects.

Causes

• Recreational and medical use both may lead to opiate dependence. People who have been in accidents, or who are in pain, have become dependent on opiates due to their injuries and pain, even under medical supervision.

Addiction

• Dependence does not necessarily mean addiction. Primarily, dependence is a physical need for a drug to produce certain effects. Pain patients may need higher doses to manage their pain better, but they are not addicted to opiates. Addiction does involve physical opiate dependence, as well as compulsive or obsessive cravings.

Effects

• Due to prolonged use of opiates, physical and psychological effects occur. Higher amounts of pain killers increase the chance for overdose and create a change in the brain's structure that grows used to opiates. If use is suddenly stopped, withdrawal symptoms occur (including sweating, pain, and insomnia, among others). Psychological problems (depression, anxiety, and poor self-esteem) stem from a need to use opiates.

Treatment

• Treatment for opiate dependence varies, including complete and sudden abstinence (which is usually the most difficult method of ending dependence, due to severe withdrawal symptoms). Many programs include stabilizing opiate usage and gradually tapering down. Different medications, such as buprenorphine and methadone, have also been used to treat opiate dependence.