About Opioid Dependence
Understanding the Stigma of Opioid Dependence
More and more, opioid dependence is being accepted as a long-term medical condition, like high blood pressure or diabetes. Yet unlike these other conditions, opioid dependence carries a powerful stigma. For example, imagine you're interviewing for a new job. You wouldn't think twice before asking whether the company's health plan covers the cost of insulin to treat your diabetes. But would you be as quick to ask about coverage of costs related to your opioid dependence?
This stigma is rooted in the long-held belief that drug dependence is a moral failure. Only within the last 20 years have researchers realized that drug dependence is a medical condition caused by changes in the brain. Today, opioid dependence in the United States is growing at a fast rate. Sadly, the stigma associated with opioid treatment deters many people from seeking help.
Removing the stigma of opioid dependence is critical to helping people get proper care. A key part of achieving this goal is wider recognition that opioid dependence is a medical condition—not a moral failing. It's not about being a good or a bad person, it's about embracing treatment, including both medication and counseling, and going forward from there.
How Tolerance Can lead to Dependence
When a person uses opioids, the brain gradually gets used to the drug and becomes less sensitive to it. As a result, the person needs more of the drug to achieve the same level of pleasurable feelings. This is how tolerance develops. With longer use or higher doses, the brain adjusts to the increased levels of opioids, and then requires those increased levels to feel satisfied or "normal" to avoid withdrawal. This is how tolerance can lead to dependence.
Physical dependence is typically associated with tolerance and withdrawal. Psychological dependence involves continued drug use despite harm. Psychological dependence can reach the point where people have uncontrollable cravings for the drug—and are willing to take significant risks to obtain it, regardless of the negative consequences to themselves, their families, their jobs, or their community.