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Prescription Drug Abuse: Who Gets Addicted and Why?

Opioid Addiction: Hard to Predict continued...

That leaves half of the risk in the "environmental" category. "This includes everything from your social group, your economic status, your family environment, and probably most importantly, stressful events during childhood," says Saxon.

Childhood trauma, like physical or sexual abuse, losing a parent at a young age, or witnessing violent acts create changes in the brain that last into adulthood. For reasons that aren't clear, these people are more prone to prescription drug abuse.

The most obvious environmental factor, though, is simply being around opioid drugs. For example, two teenagers might both be predisposed to opioid addiction. If one goes to a high school where prescription drug abuse is considered "cool," he might be more likely to use and become addicted. If the other teen is never exposed to opioid drugs, he may be more likely to stay clean.

Adults who have already abused other substances like alcohol or cocaine are more likely to fall victim to opioid addiction, as well. Smokers and young people are at higher risk, as well, according to Jamison.

People with co-existing mental health conditions like depression, anxiety, and bipolar disorder are more likely to abuse drugs in general. "These individuals are most likely self-medicating to try to feel better," but in the process they raise their risk for opioid addiction, says Levounis.

The likelihood of serious opioid addiction also goes up depending on how long someone abuses the drug. Those who abuse prescription drugs for weeks have a better chance of overcoming drug addiction than people who abuse them continuously for years.

Opioid Dependence vs. Opioid Addiction

There's an important difference between opioid dependence and opioid addiction. Anyone who takes opioid drugs for more than a few weeks will develop tolerance and some physical dependence on the drug. Usually, these people are on stable, generally lower doses of medication. If they stop suddenly, they have withdrawal symptoms (usually mild). The symptoms go away, the person is "detoxed," and they go on with life. They don't seek further chances to use the drug.

The person with opioid addiction abuses the drug to get high or to lessen anxiety. The repeated highs and rush of dopamine in the brain create the brain changes that lead to drug addiction. The high doses, and longer time of use, are also what make withdrawal symptoms such a horrible experience for addicts. The pleasure of getting high and the fear of withdrawal "rewire" the brain's reward pathway, leading to compulsive drug seeking, craving, and continued use despite negative consequences.

Whether it's a Vicodin addiction, morphine, heroin, Percocet, or OxyContin addiction, experts say the specific drug isn't important. "All these drugs are opioids, and activate the same systems in the brain and the rest of the body. From a practical perspective, there really isn't much difference between heroin addiction and addiction to any other opioid," says Levounis.

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