Opioid Facts: Pain-Related Dependence vs. Addiction

Opioids are often associated with the crisis that has grown in this country with addiction and overdoses. However, opioids can be used properly to manage your pain, when prescribed by a physician and when used responsibly. Even then, if you continue to take opioids for an extended period of time, you may find that you depend on the medication to treat your pain. The opioid facts are that there is a difference between pain-related dependence vs. addiction.

Prescription Opioids

Opioids are a class of drugs that include pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and others. These prescription pain medications can be helpful when used correctly, under a healthcare provider’s direction and supervision.

The rate of opioid prescribing by physicians in the US peaked and then leveled off from 2010 through 2012 and has been declining since. The reduction rate in opioid prescribing was more than 19% from 2006 to 2017. Healthcare providers are becoming more cautious in prescribing opioids for pain management.

However, in 2017, there were still almost 58 opioid prescriptions written for every 100 Americans. The dosage of opioids prescribed per person continues to be about three times higher than in 1999 and the average number of days per prescription continues to increase, with an average of 18 days in 2017.

The Opioid Crisis

When opioids are misused or abused, they can cause serious and sometimes devastating consequences. If you take prescription opioids for longer periods of time or in higher dosages, it can increase your risk of opioid use disorder, overdose, and even death. It is critically important you discuss the risks of opioids with your healthcare provider. In turn, your provider should offer fewer prescriptions for fewer days and at lower dosages, offering alternatives to pain-related medications.

According to the National Institute on Drug Abuse (NIDA):

  • Approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
  • Between 8 and 12 percent develop an opioid use disorder.
  • An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
  • About 80 percent of people who use heroin first misused prescription opioids.
  • Among 38 states with prescription opioid overdose death data, 17 states saw a decline between 2017-2018; none experienced a significant increase.


Pain-related dependence on opioids can occur when you take the medication as prescribed by your healthcare provider. Dependence is not addiction. Rather, dependence essentially means that you will feel withdrawal symptoms when you stop taking the drug. Physiological features of dependence can also include increased tolerance to the effects of opioids or repeated use of opioids or pharmacologically similar substances to prevent or alleviate withdrawal symptoms. Researchers have found that the abnormalities that produce dependence appear to resolve after detoxification, within days or weeks after opioid use stops.


In contrast, addiction may involve an interaction of environmental effects—for example, stress, the social context of initial opiate use, and psychological conditioning—and a genetic predisposition in the form of brain pathways that were abnormal even before the first dose of opioid was taken.

Unlike dependence, addiction is considered a chronic disease that is characterized by drug seeking and use that is compulsive and difficult to control, regardless of the consequences. While the initial decision to take drugs may be voluntary, or may have been initiated by a legal prescription for opioids for pain management, repeated drug use has been found to lead to brain changes that challenge an addicted person’s self-control. Addiction interferes with your ability to resist intense urges to continue to take drugs.


When you are experiencing pain-related dependence or addiction to opioids, withdrawing from these drugs can be challenging and could even be dangerous if done without medical supervision.

Symptoms of withdrawal can include:

  • Diarrhea, runny nose, excessive sweating, crying, shivering, nausea, vomiting
  • Central nervous system arousal – sleeplessness, restlessness, tremors
  • Pain – abdominal cramping, bone pains, and diffuse muscle aching
  • Craving for the medication.

Detox and withdrawal should be managed by a professional healthcare provider and may include therapies as well as pharmacology treatment options.

Contact Recovery Without Walls for Help

At Recovery Without Walls, we provide you with confidential treatment for your opioid dependence or addiction. We start with comfortable, caring, physician-directed detoxification and then work with you on innovative pharmacological intervention and integration. As an evidence-based medical practice, we are focused on your comprehensive health and continuing recovery. Our professional staff provides individualized treatment, to address your specific needs in a whole-body approach. During COVID-19, we believe that early intervention can save lives and we urge you to contact us today for help.