By JENNY CHEN OCTOBER 26, 2017
Yale Medicine experts share opinions on common misconceptions that may be preventing people from getting help.
Between 2015 and 2016, drug overdose deaths went from 33,095 to 59,000, the largest annual jump ever recorded in the United States. That number is expected to continue unabated for the next several years. We talked to a panel of Yale Medicine experts who weighed in on the three most harmful and widely held misconceptions that are preventing large groups of people from getting treatment
Myth #1: Opioid addiction is just a psychological disorder and people who are dependent simply need better willpower. Richard Schottenfeld, MD, Psychiatry
It’s important to define opioid addiction carefully, because the stigma is so strong. Someone who is prescribed opioid medications for pain for prolonged periods may develop tolerance, which means they need a higher dose to get pain relief. Or they may experience withdrawal symptoms when they stop taking the medication. But these are not considered cases of opioid addiction.
Opioid addiction, or technically “opioid use disorder,” is defined as loss of control over use of opioids. This means that the person continues to use opioids despite negative consequences or is unable to stop using opioids despite wanting to. This person may also have a preoccupation with using opioids, obtaining opioids or craving for opioids. These patients may also develop tolerance or experience withdrawal when they stop using, but those symptoms by themselves do not define an opioid use disorder.
Some people think that an opioid addiction is just psychological or a weakness of character, and that people who are addicted simply don’t have the willpower to stop. But it’s more complicated than that. Long-time use of opioids in an addictive way actually alters brain functioning. It causes chronic and lasting changes in the brain reward system, causing the person to feel less motivation and get less pleasure from other, naturally occurring rewards. Opioids become the primary reward and the primary focus of the person’s life, and they need more of it to activate the reward system.
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