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Prescription Drug Abuse: Who Gets Addicted and Why?

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Opioid Addiction: Hard to Predict continued...

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.

Addiction Calls for Compassion, Not Condemnation

Whether or not someone is susceptible to opioid addiction depends on genes and early experiences. Studies have shown that when opiates are taken exactly as directed, they are safe, can manage pain effectively, and rarely cause addiction. When a person begins to experience signs of prescription pain medication abuse, he or she can avoid drug addiction -- defined as the compulsive and uncontrolled use of drugs despite adverse consequences -- by stopping use completely. But once true opioid addiction takes hold, the condition can be as firmly rooted as other chronic diseases like diabetes or high blood pressure, experts believe.

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