"Opioids are 'heroin pills.' Anyone using opioids long-term is addicted."
Substance Use Disorder (SUD) is a specific medical diagnosis that is different from dependence. Physiological dependence results from frequently taking opioid pain relievers, and will affect nearly everyone who takes these medications daily for weeks or more — regardless of harm or benefit. This means that when medication is stopped, withdrawal symptoms follow.
Regular medical use of opioids may have benefits for some, such as chronic pain patients or folks on maintenance treatments for SUD. Ignoring these benefits can be harmful for patients who find a better quality of life thanks to opioids. Demonizing opioids and over-hyping the harms associated with dependence further marginalizes patients engaging in health care.
The Informed Narrative:
Addiction is defined by the National Institute on Drug Abuse (NIDA) as:
"A chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences." This differs from "physiological dependence," an inevitable outcome that results from the continued use of many medications–– not just opioids. Physical dependence lacks behavioral elements that are the hallmark of addiction, or substance use disorder.
Past public health campaigns have demonized drugs. Such efforts are counterproductive for pain patients and people with addiction. "Scared-straight" campaigns are also demonstrably ineffective. A variety of highly individual factors––genetics, mental health, and social environment––affect how people respond to drugs. These factors must be taken into account when covering drug use.
The Tired Narrative:
Journalists frequently use the terms "addiction" and "dependence" interchangeably. For example, patients on long-term opioid therapy are described as being "addicted" to their medication, since they will experience painful withdrawal symptoms if they abruptly cease use. Opioid pain relievers are also said to be "indistinguishable" from heroin.
The former director of the Centers for Disease Control and Prevention once described the "opioid epidemic" as "doctor-driven." Other experts describe pain relievers as "heroin pills." Journalists have taken statements like these to mean that people who are prescribed opioids to manage long-term pain are in the same category as patients who have a substance use disorder.
Connect with Expert Sources:
Maia Szalavitz, Neuroscience Journalist
Kate Nicholson, attorney/pain advocate
Dr. Stefan Kertesz, University of Alabama, Birmingham