Tag Archives: addiction

Difference Between Drug Addiction and Dependence

Is There Really a Difference Between Drug Addiction and Drug Dependence? – Scientific American Blog NetworkBy Jonathan N. Stea -November 2019 (repost)

As a follow-up to a previous post, Addiction vs dependence | National Institute on Drug Abuse, here’s an article from the Scientific American pointing out the messy confusion between the two created by the DSM-5.

It is no secret that misinformation about addiction is rampant in popular media. One particular area of misinformation concerns what language gets used when describing topics related to addiction.

all sorts of individuals—medical professionals, journalists, parents, people who use substances, people in recovery—incessantly argue over terminology such as “addiction,” “dependence,” “abuse,” “misuse,” “habit-forming,” “recreational use” or “medicinal use.”   Continue reading

In Defense of the Concept of Addiction

In Defense of the Concept of Addiction – by Stanton Peele – Jan 2020

The term—and concept of—“addiction” is regularly frowned upon or even attacked by people in our field. But it won’t disappear, nor should it. There are four groups or schools of thought that de-emphasize or disparage “addiction.” And their reasons for doing so all have value.

Psychiatry:

Psychiatry in the latest DSM-5 claims it didn’t want to stigmatize people with the term “addiction”, so it completely muddled the difference between doing something regulated and appropriate on a regular basis (taking prescription opioids) versus binging on street drugs (heroin, amphetamines, cocaine), becoming addicted, and ending up overdosing.  Continue reading

Most People Don’t Feel Euphoric From Opioids

Most People Don’t Actually Feel Euphoric When They Take Opioids, Study Finds | Live Science – By Nicoletta Lanese – Staff WriterOct 2019

Finally, someone is willing to state the truth, one that goes against all the rabidly anti-opioid media hype:

Opioids jump-start the brain’s reward system, provoking a burst of pleasurable feelings along with a dizzying drug-induced high. At least that’s what scientists used to think.

But mounting research suggests that the average person doesn’t actually reach this euphoric state on opioids, particularly not the first time they try it.  

Yet, this is exactly the kind of research that is not getting funded these days.   Continue reading

Addiction vs dependence | National Institute on Drug Abuse

10: Addiction vs dependence | National Institute on Drug Abuse (NIDA) – Nov 2019

We have an entire government institute that is dedicated to handling drug abuse issues. NIDA is not connected to the DEA in any manner and has much experience and knowledge about addiction, but their expertise is being ignored.

Here, the true experts on addiction give a lengthy explanation of how the brain region leading to addiction is entirely separate from the region that controls dependence and tolerance.

This is a slide show with diagrams to illustrate the points they make. Click on the link of each section to see the slides.

different parts of the brain are responsible for the addiction and dependence to heroin and opioids.

Continue reading

Only 1% Continue Opioids After Emergency Rx

Only 1 Percent of People Become Chronic Opioid Users After Hospital Prescriptions for Injuries, Study ShowsBy Blake Dodge – Nov 2019

This destroys the myth of “heroin pills” that “cause” addiction after “just a few pills”. And this tiny fraction of patients could very well be the ones that suffered long term damage from the injuries that sent them to the ER in the first place.

People who are prescribed pain medication after they visit the emergency room for car crashes, falls and other types of acute injuries largely do not become addicted to opioids, a new study showed.

The results go against the widely held understanding…

It’s more like malicious ignorance due to a complete lack of understanding and, in some cases, a blatant refusal to understand.  Continue reading

Difference Between Drug Addiction and Dependence

Is There Really a Difference Between Drug Addiction and Drug Dependence? – Scientific American Blog NetworkBy Jonathan N. Stea – Nov 2019

In my experience as a clinical psychologist and, dare I facetiously say, a Twitter addict, the most important and commonly confused distinction is between “addiction” and “dependence.”

And it is no wonder.

This deadly (to pain patients) confusion is due to the psychiatric “bible” which either unintentionally or intentionally erased the difference between the two.

The latest version, the DSM-5, now hides “addiction” as a category of “dependence”, even though these are two very distinct issues.  Continue reading

More Reasons For Opioid Policy to Shift

Data From Germany Provide More Reasons For Policy to Shift From Prescription Pills to Harm Reduction – Cato.org – By Jeffrey A. SingerAug 2019

In February of this year, I co-authored a paper in the Journal of Pain Research explaining why there is no correlation between the amount of opioids prescribed and the incidence of non-medical use or prescription pain-reliever use disorder.

See my post on this paper: Non-medical opioid users were not pain patients

Now researchers in Germany have provided more evidence to pour cold water on the idea of any relationship between the volume of opioid prescribing and the incidence of opioid use disorder.   Continue reading

Addiction Is Not Dependence

Addiction Is Not Dependencepracticalpainmanagement.com – Aug 2019

In this editorial, Jennifer P. Schneider, MD, PhD, digs into a common—and frustrating—misunderstanding in pain medicine terminology.

FDA approved the buprenorphine implant, branded as Probuphine, in 2016 “for the maintenance treatment of opioid dependence.”

  • Was it approved for the treatment of what we now call Opioid Use Disorder (OUD)?
  • Or was the intent to approve it for physical dependence, a condition found in most opioid-treated chronic pain patients as well as opioid addicts?

It is not clear from the language.   Continue reading

DSM-5 Criteria for Opioid Use Disorder

DSM-5 Criteria for Diagnosis of Opioid Use Disorder– from American Psychiatric Association

These are the latest diagnostic criteria for what used to be called addiction. They make it seem like everyone on opioid therapy for chronic pain has “opioid use disorder” (OUD).

The writers of this new version of the manual thought the term “addiction” would be stigmatizing, so they created this new disorder as a continuum of “dependence”, further erasing the line between “use of opioids” and “addiction to opioids”.

It makes me think they themselves can’t see the difference that’s so obvious to us. Or perhaps they relied on addiction specialists, most of whom see any use of opioids beyond 90 days as an “opioid use disorder”.   Continue reading

Real Overdose Data from NIDA

Here is a whole page of some excellent charts from the National Institute of Drug Abuse (NIDA). – July 2019

NIDA has the most accurate, up to date, and pertinent information, since it’s the federal agency whose mission it is to deal with drug abuse, not the CDC or FDA.

Below is the chart showing that it’s illicit Fentanyl that’s increasingly involved. Note that in the numbers for prescriptions, the opioids are almost always not prescribed to the person overdosing.