It’s important to know that any chemical use, including prescription painkillers, involves a variety of levels of use. How each particular individual interacts with the drug determines whether the use of this medication is more harmful or helpful.
The three categories typically used are: use, abuse and dependence. There are three stages of dependence: diagnosis; mild, moderate and severe with specific criteria for each of them. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) uses the following list of criteria to determine the severity of an individual’s dependence.
- Taking a substance in larger amounts and/or for longer than initially meant to
- Wanting to cut down or stop using the substance but not managing to
- Spending a lot of time (getting, using or recovering) from use of the substance
- Intensive cravings or urges to use the substance
- Not managing to do what you should at work, home or school because of substance use
- Continuing to use, even when it causes problems in relationships
- Giving up important social, occupational or recreational activities because of substance use
- Using substances again and again, even when it puts you in danger
- Continuing to use even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
- Needing more of the substance to get the affect you want (tolerance)
- Development of withdrawal symptoms, which can be relieved by taking more of the substance (APA, 2013)
Severity Qualifier Breakdown
Having 2 within 12 mo. = Substance Use Disorder exists
Having 2 to 3 = Mild
Having 4 to 5 = Moderate
Having 6 or more = Severe
When anyone uses pain medication, its purpose should be for that alone – to remove pain. That is not wrong in and of itself. With proper oversight, doctor accountability and a weaning goal, this type of usage can safely fulfill the purpose for which it was prescribed.
However, over time, use can become abuse. Once prescriptions are abused, a person starts to engage in taking more of it and more frequently than prescribed, while seeking alternative ways to get prescriptions filled. This is always a dangerous practice, and can very quickly evolve into a dependence.
A person that becomes dependent on a prescription medication doesn’t necessarily have to be abusing their prescription for it to happen. It may simply be that the pain medication was taken over a long enough period of time that the body has adapted to its presence. Now, without the drug, withdrawal symptoms quickly surface. While they may seek help to overcome the physical withdrawal, a psychological dependence may already be in place that will need attention as well.
The person that abuses opioid derived medication is far more likely to develop an addiction. The presence of addiction is categorized by an obsessive, compulsive need to attain more of the drug, even at the cost of severe risk. A person with an addiction may give up everything they consider important just to have drugs. Thus, an addiction takes over the person’s entire life. It not only affects the body, but also the emotions, the mind, the spirit, work, responsibility, family and relationships.
People with prescription pain medication addiction, often find it difficult to feed their increased need through their physician written prescription, and are very vulnerable to switching to other options found on the street such as heroin.
Heroin is much easier and more affordable to access; but will in turn throw that person into a full lifestyle of addiction to drugs that could have legal, physical, spiritual, emotional, financial and relational consequences that know no bounds.
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