The Difference Between Opioid Dependence vs. Addiction
While the two are related and can be connected, there are important distinctions between opioid dependence vs. addiction. “Dependence” is when you need something; addiction is when you desire something. In other words, opioid dependence vs. addiction comes down to “need” versus “want,” though opioid dependence can lead to addiction.
First, what are opioids? We have all heard of the opioid epidemic, which is currently affecting millions of people, and it involves all types of opioids from strongest to weakest. Often, an opioid, or a painkiller that is derived from the poppy seed, is prescribed to treat pain. These include oxycodone (Oxycontin), hydrocodone (Vicodin), and more illicit variations such as heroin and fentanyl. In 2020, 75% of drug overdoses were related to opioid abuse, according to the U.S. Department of Health and Human Services — and the number continues to rise.
What Is the Definition of Opioid Addiction?
Opioid addiction is different than dependence. Some people require opioids for pain and can use them responsibly. However, because of the nature of addiction, many will begin to ignore the fact that the substance is helping their pain and, instead, focus on the euphoric feelings it produces. We have natural receptors in our brains that respond to an opioid’s presence. When taken, many people report a sense of intense euphoria and sedation. Opioid addiction is defined as: “…a chronic and treatable mental health condition that involves a problematic pattern of opioid misuse,” according to the Mayo Clinic. In other words, opioid addiction is the use of a prescribed or illicit substance that contains the properties of the poppy seed for purposes other than to relieve pain. Rather, it is used to get high or “feel good.”
How Long Does It Take to Develop Opioid Dependence?
To answer this question is nearly impossible. Opioid dependence can develop in a day, a week, or over a span of years. Dependence, unlike addiction, means that you require the substance to treat pain. The difference between opioid dependence vs. addiction is that dependence means it is a requirement to live your daily life. Addiction, however, links with strong cravings and physical or psychological effects that are only cured by ingesting more of the substance. When not under its influence, the person withdraws, which is uncomfortable and can be dangerous.
That’s why the answer to the question depends on each person. Dependence on opioids does not always lead to addiction, but it can be estimated that if someone is in chronic pain, and the opioids assist in relieving it, then it is a dependency. Again, we are all different. Opioid dependence (and how long it takes for it to occur) varies based on many factors, including addictive tendencies, which can come from lifestyle choices, genetic predisposition, and, most importantly, the dosage and strength of the opioid in question. Heroin or fentanyl, for example, are two substances that differ greatly from a typical painkiller. Many report an immediate addiction to these substances, whereas with prescribed opioids (such as Vicodin or Oxycontin), it may take time for the body to “require” it.
What Is the Difference Between Opioid Addiction and Opioid Tolerance?
The difference between opioid addiction and opioid tolerance is simple to explain. When the body becomes used to something, such as an opioid’s chemical properties, tolerance occurs. This is when it is consumed regularly, as the chemical becomes customary. Thus, it is not addiction — yet — until the user begins to up the dose or misuse the medication or substance to receive the desired effects (yes, this can include relieving pain). This is where opioid addiction starts: Tolerance can lead to requiring a higher dose, and this can then cause the person to take more than prescribed. It is very common for this method to escalate quickly.
The moment you begin to up a dose without authorization from a doctor, the body grows more and more used to its existence, and soon it can develop into addiction. Thus, the correlation between opioid addiction and opioid tolerance is simple: opioid tolerance is when the body is used to the substance, often leading to people taking a higher dose to achieve the same desired effects, and this can lead to addiction. If you need help, WhiteSands Treatment can provide the therapy and treatment you need to overcome opioid addiction.
What Is Considered Long-Term Opioid Use?
Long-term opioid use is, again, hard to describe. A study by BNJ, an independent research firm, states that the most crucial factor is held within the first month. The risk of addiction can be a likelihood of 24% after a mere 12 days of opioid use and around 43% after one month of use. Notedly, the dose of the medication and its strength drastically affect the factor of long-term opioid use. As an example, morphine is much more powerful (and thus, more likely to cause addiction) than Vicodin, and fentanyl is 50-100 times more potent than heroin. Therefore, there is no single factor that defines long-term opioid use. However, using these notes as benchmarks, it is clear that opioid addiction can develop within less than two weeks of use. This is why billions of dollars have been spent to combat the opioid epidemic.
How Opioids Work in the Brain
Opioids bind to parts of the brain called receptors. These are a part of the central nervous system, and when an opioid is ingested, the receptors reduce the activity of pain signals, hence why they are typically called painkillers. However, this releases neurotransmitters (chemical messengers in the brain that communicate between neurons) like dopamine. This causes a “feel good” effect, and dopamine is responsible for reward. It releases a pleasurable feeling because the body associates it with survival, but it is a false response.
The body becomes aware that this is releasing the reward chemical, which causes an intense desire for more. Take, for example, a 2009 study on lab rats. When the rat pushes on a lever, it triggers dopamine release. The rats, over around a week, began to neglect survival needs such as eating and sleeping. They would simply press the lever for that “feel good” response, and many died because of this. Opioid addiction is no different.
WhiteSands Treatment Can Help with Opioid Dependence vs. Addiction
Opioid dependence vs. addiction is a topic that needs to be discussed because it is an epidemic that is sweeping the nation. With opioid overdoses increasing, it is important to understand the facts. If you are struggling with an opioid addiction (or any other substance abuse), please call us at 877-855-3470. Don’t be a victim. We offer a unique, dual-diagnostic approach to treatment, and all plans are customized for each patient. At WhiteSands Treatment, we can help.
External Sources
- U.S. Department of Health and Human Services — Opioid Facts and Statistics
- Mayo Clinic — How Opioid Use Disorder Occurs
- BMJ — Rethinking “Long Term” Opioid Therapy
- National Library of Medicine — Dopamine Modulates Effort-Based Decision Making in Rats
If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.
About the Author
Jackie has been involved in the substance abuse and addiction treatment sector for over five years and this is something that she is truly eager about. She has a passion for writing and continuously works to create informative pieces that not only educate and inform the public about the disease of addiction but also provide solutions for those who struggle with drug and alcohol abuse.
