Abuse, Addiction, and Withdrawal

A major concern with the prescribing of opioids is to ensure that they are used to treat pain and not abused for the euphoric effect that some people get when they take them. The federal government demands that physicians who prescribe opioids to do for a legitimate medical purpose and they do not prescribe for either abuse or diversion. Every State Medical Board expands upon these prescribing requirements. For example, physicians should do a physical exam on every patient for whom medication is prescribed, making the Internet prescribing of medications illegal. These issues are of particular concern in that the largest area of growth in drug abuse is the use of prescription medications rather than street drugs.

Many patients are concerned about addiction. Addiction is a confusing word, in that it has two meanings: physical addiction and psychological addiction.

Physical addition means that the body is used to having the narcotics on board. Abruptly stopping the medication can lead to withdrawal symptoms such as:

• flu-like symptoms,
  
  
• nausea,
  
  
• vomiting,
  
  
• diarrhea,
  
  
• bone aches,
  
  
• feeling like you are "crawling out of your skin,"
  
  
• goose bumps,
  
  
• chills,
  
  
• tremor, and
  
  
• difficulty sleeping.

These symptoms are all medical concerns and should be treated medically. Many drugs, including some antiseizure medications, antihypertensive drugs, and steroids, if stopped abruptly, can have major medical side effects. One should not stop taking opioids unless under the direction of a physician.

Psychological addiction refers to craving for the narcotics, where the focal point of one's life is getting the opioids. Some people's brains are hardwired to crave narcotics. This drive is difficult to control and requires specific medical treatment. Patients suffering from psychological addiction are not good candidates for narcotic therapy to treat pain