ATrain Education


Continuing Education for Health Professionals

Opioid Epidemic: How Did We Get Here and Where Do We Go Now?

Module 3

Definitions of Use and Abuse

Clarifying the difference between dependence and addiction is important to better understand the issues in opioid use and abuse. Dependence is the physical tolerance of the drug that requires increased amounts of the drug to achieve the desired response. Withdrawal of the drug will result in physical symptoms such as shaking, tremors, nausea, and vomiting. Addiction is a behavioral disorder that refers to the emotional desire for the drug and the desired effects it brings, which often creates strong drug seeking behaviors. Generally, those who are dependent on opioids will vary between feeling sick without the drug and the desired high after taking the drug. Being addicted to the drug will motivate a person to do whatever it takes to get and take the drug to avoid the dreaded withdrawal symptoms.

Withdrawal symptoms include the following:

  • Intense drug cravings
  • Depression, withdrawal fears, anxiety
  • Sweating, watery eyes, runny nose
  • Restlessness, yawning
  • Diarrhea
  • Fever and chills
  • Muscle spasms
  • Tremors and joint pain
  • Stomach cramps
  • Nausea and vomiting
  • Elevated heart rate and blood pressure (NIDA, 2015; Kosten & O’Connor, 2013).

People at risk for opioid dependence and addiction are seen in every age, gender, ethnicity, and culture. Physical dependence varies. A genetic component has been identified that influences how quickly a person may slide from occasional use to physical need and addiction to the drug (Kreek et al., 2005). Susceptible populations have typically included the homeless, alcoholics, and those with personality or mental health disorders who look for a way to block the emotional pain of life stressors. Healthcare professionals, who experience great work stress, have a higher risk of becoming dependent or addicted to opiates following back or other injuries and having easier access to narcotics in their work setting (Kenna & Lewis, 2008).


Answer: C

Test Your Knowledge

What is the definition of dependence?

  1. A drug user who wants the drug for a party
  2. The drug user who depends on his dealer for a steady supply
  3. A person who uses the drug regularly and now physically depends on an increase of the drug
  4. The person who takes opioids occasionally for entertainment and to feel pleasure

Apply Your Knowledge

Q: What are the first symptoms you see when a patient has had too much oxycodone?
A: Change in level of consciousness and pinpoint pupils.

Online Resource

YouTube: CDC Releases New Statistics on Nation’s Opioid Crisis

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