Question on Opiate Addiction

[Sportsguy86]

My question pertains to the difference in addiction recovery from patients who had become depend on opiates after long use BUT only for pain management purposes and not for euphoric highs (Person 1) with those who don't need it for pain only for their "fix" (Person 2).

So, that said, my question is this: It's not a secret that long-term opiate use causes changes to receptors in the brain and endomorphins. So, both Person 1 and Person 2 are physically dependent, and upon stopping will go through physical withdrawals, regardless of their motivation for originally taking the drug. This I know. Here's where things get interesting.

Long-term opiate causes changes in the brain that is still there for a period of time AFTER physical withdrawals have passed, such as depression, anxiety, and strong cravings. This is a chemical change in the brain that results only from long-term opiate use, NOT on the user's motivation.

So, after physical withdrawals have passed and arguably the even tougher part begins of avoiding relapse, isn't Person 1 in similar shape to Person 2 simply because of the chemical changes in their brain, even if they werent doing it to get high?

I'm confused with this because I've heard so many times that if you're only taking it for pain purposes, you will be physically dependent but not mentally. But proven changes in the chemistry of the brain prove otherwise.

I would appreciate any insight here. Thanks.

[Dole654]

An opiate addiction is an opiate addiction. I'll look for some relevant studies...

[OhCasey]

Originally Posted by Dole654

An opiate addiction is an opiate addiction. I'll look for some relevant studies...

He's not asking to compare addiction and addiction hes asking to compare addiction and tolerance. This is tricky cause it really goes into rather you believe what alot of scientist and most addiction specialist believe which is most addicts are predispostioned to addiction. Pain Doctors say that pain meds and Opiates in particular effects people in pain differently. So as far as your question yes the cravings anxiety and depression would be present in someone with a dependence and not an addiction. The anxiety cravings and depression should last no longer then a month though, also if said person was in pain and stopped taking meds they would be far less stressed/anxious and depressed from all the constant pain being relieved that the opiate withdrawal should seem like nothing especially since most docs would have the patient taper at the end of treatment so that withdrawals would be minimum. Also a good doc would perscribe something like klonopin to also help. If you were still in constant pain and were stopping all use of opiates and had used a taper i would imagine the pain might be so powerful that the withdrawals might seem minor as well. It's probably just a person on person basis some patients in pain might be addicted and therefor would have withdrawals just as bad if not worse then normal addicts with the continued want to use long after withdrawals. Its the opposite with people who are able to do opiates on numerous occasions and never develop any dependence or addiction, these are probably the same people who if they have some sort of prolonged pain are on opiates until the pain is gone and use opiates sparingly if not never again without a second thought. They say that most addicts have addictive personalities and are wired different from birth. I like many others believe its genetic. Hope this helps answer your question.

[nancydrew]

good question! swim initially began taking opiates for pain management purposes when she was 13. while dosing directions were always followed, she distinctly had this "where have you been all of my life?" type feeling in regards to her new medication. swim was only taking 10mg hydrocodone/apap 3x a day. after several years and changing to various stronger medications, swim had clearly developed a physical dependency on the drug and noted that her quality of life had degraded. swim had surgery to deal with the problems that caused the chronic pain with good success and decided it was time to stop taking the pain medications. not really knowing what she was getting herself into and with no medical assistance, she went cold turkey. the symptoms were amazingly awful but seemed to subside after two weeks. the depression however was another story. this seemed to go on for another 2 months at which point swim relapsed but on heroin this go around. withdrawal symptoms were absolutely the same and swim encountered quite a bit of issues with depression/anxiety/stress.

[finriswolf]

Originally Posted by nancydrew

withdrawal symptoms were absolutely the same and swim encountered quite a bit of issues with depression/anxiety/stress.

Did swim have issues with depression before the run with opiates? Or was the depression directly related strictly due to the withdrawls? this SWIM hopes that depression is not in the cards with a planned cold-turkey stop (again) soon because swim has never had those types of issues before using.


Thanks and good post

[bloodred1889]

i have to agree with the person who said an addiction is an addiction.

swim takes opiods for chronic pain, and is suffering from withdrawel as we speak.
it sucks.
but then again swim does like the high opiods produce, so you could say its also recreational.
but swim knows that no matter what the reason the outcome would be the same, she would be sitting here right now awake at 3am sweating like a pig with really annoying pains, even after taking 3 opiod tablets. see it also causes bloody fucking tolarence.

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terrible post we are all dumber having read her posts

[samuraigecko]

SWIM also agrees that addiction is addiction in almost every case. However he also has to agree with OhCasey here (w00t) on some of the points made.

The addiction itself can be subjective and a person whom was taking the opiate purely for pain relief may recover their endomorphin system easier just because they are relieved to finally be out of pain. This sense of relief that they are finally no longer in pain may be productive in getting the endomorphin system back on track faster.

An addict whom is taking the drug purely for pleasure will not have a reward goal to help their endomorphin production resume and therefor may take longer to recover their endormorphin production in their brain.

The brains natural reward system includes the endomorphin system. It seems logical that if one were to finally be relieved that they are no longer in severe pain that they would feel some kind of reward. This stimulation of the endomorphin system may be of extreme help in the road to recovery. For this same reason counselors use a reward system for addicts whom use for pleasure, helping them to feel good about themselves in an effort to give the endomorphin system a nudge or two.

Just ones opinion, and it is conjecture of course, but it makes sense to SWIM.

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hes just wrong

[bloodred1889]

that sounds very interesting, but when one is addicted for pain or pleasure surly when you take a hit and the high comes back and takes away the pain of withdrawels does that also count as a relief to pppl who are just taking for plesure?

swims abit confused.

[OhCasey]

Some people take opiates for pain management for long periods of time and never develop addiction. For the most part Medical Doctors believe that Pain meds like Opiates affect those in pain differently then those who are not. But like anything else it depends on the person. Since Addiction specialists believe most cases of addicts are hereditory. Also "when used properly under the care of a physician, opiates can relieve severe pain without causing addiction." So according to most doctors and medical professionals when opiates are taken as directed by a Doc there is little chance for addiction, its when Opiates are taken more frequently or abused that people become addicted, but its similar to the chicken and the egg. Do pain patients become addicts because they abused there scripts or did they abuse there scripts because they were predispostioned to become addicted or maybe both? But im positive that when the need for opiates has stopped theyre millions of individuals who stop taking them and with a good taper feel little to no urge to use again. Ive met alot of individuals through my pain doctor who because theyve tried surgery or other procedures have been able to eliminate opiates and they deal with it pretty well but that may be from the happpiness experienced from not living in pain.

[MotherSuperior]

Intresting. Swim used to be very bad opiate addict, taking Methadone !V 200mgs + whatever else... and SWIM means a LOT else(checkout SWIMs out posts and you'll see).

Now amaongst other problems SWIM has chronic pain issues for which SWIM gets Dihydrocodeine, breakthough Morphine and if in bad pain asks doc for Oxycontins and has always got ample pain provision.

SWIM still uses street Heroin but very little(SWIM's rule is .5 once a week
at most... SWIM recently went into WD's from overindulging SWIMS little treat but had script meds to make it not so bad... bad WD's lasted 2 days total about a week). SWIM only knows that for SWIMS self TWO things are true. 1/ SWIM finds that physically it takes MUCH less time than opiate niave people(SWIM is experienced RN so...) to get tolerant and 'addicted' to higher doses of opiates 2/ SWIM in any case needs a much higher dose of prescription opiates to deal with pain than opiate naive people would(Interms of SWIM takes 120mg/QDS+ 20-30mg MST + 20-40mg of Oxy if needed).


SWIM therefore concludes that not sure if either addict or 'pain' user but previous use does affect SOME brain chemistry functions forever... or maybe for SWIM or maybe related to SWIMS time on opiates... hey they never teach this stuff at Nursing school or when I trained medical school

[OhCasey]

Im sure that people who take opiates for pain and are not addicted still experience the happiness opiates bring but not like they do for addicts. This is probably because they use it to keep pain in check and not to get high or in case of some addicts both the high and pain relief. Its interesting how the op asked clearly about addiction and dependence and more then one poster generalizes by saying "addiction is addiction". I think its hard for people who are addicted to substances to see that some people can take the same substances and not become addicted. Not that im making the judgement that anyone here is an addict there just seems to be this attitude here that anyone who indulges in drugs is or will soon be addicted.

[samuraigecko]

People can take the same substances and not become addicted. Some may become addicted rather quickly and others may take time, every persons body and reaction thereof is different after all.

People can take the same substances and not become addicted . . . . . for a time.
With opiates / opioids one is sure that almost everyone will agree that if continued use over a significant period of time is involved then addiction is inevitable.

This is not to say that everyone will become addicted if opiates / opioids are taken. However, if they are taken over a significant period of time and regularly then everyone whom takes them in this way will become addicted.

If an opii is taken for a legitimate reason and taken as directed etc then the chances of addiction are reduced, especially if the duration of the medication is not over a significant period of time. People should not be scared of opiates in this circumstance because good pain management will either have a safe duration or a good plan for opiate "weening" in place if the duration is needed to be longer than normal.

That said, if opiates are taken at a rate higher than directed or for recreational usage just to get high then the chances of addiction are higher and if continued in this manner, inevitable.

[OhCasey]

Originally Posted by samuraigecko

With opiates / opioids one is sure that almost everyone will agree that if continued use over a significant period of time is involved then addiction is inevitable.

Ya me and the Global medical community are going to have to disagree.

[samuraigecko]

Originally Posted by OhCasey

Ya me and the Global medical community are going to have to disagree.

you and the GLOBAL medical community? did you ask them? LOL

Talk to some medical professionals. SWIM himself is on pain management and asks these types of questions from clinical specialists all the time.

Even people on opiates for legitimate reasons get addicted after a certain period of time, especially when the dosage needs to be increased because of the duration.

WD effects can be anything from a foul mood for a week or two to full blown WD if the opiate weening has not been managed right.

To help avoid this in a clinical setting most pain management specialists will use a weening regime dependent on the case they are working with at the time. This helps to either ease or stop WD from ever happening.

This is not to say that even someone on pain management will not be addicted. An example would be to take the persons pain medication away from them (someone whom is in advanced staged of pain management). They almost certainly WILL go into withdrawal as well as their pain returning because it is not being managed.

Speak for yourself and not for the GLOBAL medical community, this helps others whom are easily influenced on discussion boards from being mislead.

[OhCasey]

Originally Posted by samuraigecko

you and the GLOBAL medical community? did you ask them? LOL

Talk to some medical professionals. SWIM himself is on pain management and asks these types of questions from clinical specialists all the time.

Even people on opiates for legitimate reasons get addicted after a certain period of time, especially when the dosage needs to be increased because of the duration.

WD effects can be anything from a foul mood for a week or two to full blown WD if the opiate weening has not been managed right.

To help avoid this in a clinical setting most pain management specialists will use a weening regime dependent on the case they are working with at the time. This helps to either ease or stop WD from ever happening.

This is not to say that even someone on pain management will not be addicted. An example would be to take the persons pain medication away from them (someone whom is in advanced staged of pain management). They almost certainly WILL go into withdrawal as well as their pain returning because it is not being managed.

Speak for yourself and not for the GLOBAL medical community, this helps others whom are easily influenced on discussion boards from being mislead.

Actually ive asked plenty of doctors and i have read up on the subject vigorously for the last 4 years of my life. I've read countless articles and study on the internet. There have been plenty of friends and family membersthaat have sent me internet sites and mailed me newspaper articles regarding the subject of pain.

I dont speak for the global medical commntiy because i dont have to, almost all if not all pain specialists agree that this statement

Originally Posted by samuraigecko

With opiates / opioids one is sure that almost everyone will agree that if continued use over a significant period of time is involved then addiction is inevitable.

Is anything but true.
Ive read your posts before and you seem to be knowledgeable in some other areas but you need to inform yourself on Pain Management and Addiction i dont care if you are in pain or if youre an addict you just plain and simple have it wrong.

Speak for yourself and not for the GLOBAL medical community, this helps others whom are easily influenced on discussion boards from being mislead.

This statement really irks me cause clearly you didnt do any research. I'd understand if you asked me to present a source or did research to prove me wrong but to just say im wrong without doing the simplest of searching isnt helping those who are easily influenced on discussion boards from being mislead. I went straight to google after reading this and searched pain management and addiction the first hit was an article by MSN Health & Fitness (Which i read when an article catches my eye) and i find them very reliable. I understand people not wanting t take my word so here this was taken from "The Truth About Painkillers"
Myth No. 6: Addiction is inevitable if opioids are taken long-term or in high doses—and the risk of addiction is very high for short term use.
This myth stems from confusion about the nature of addiction. Many people believe that addiction is simply needing a substance to function—but if this were the case, everyone would have to be considered addicted to food, air and water. “To the average person, addiction is going cold turkey— they view addiction as physical dependence,” says [Dr. Gavril] Pasternak.
In fact, psychiatry defines addiction as compulsive use of a substance despite negative consequences—and it is this craving, impairment and loss of control that people fear. However, while most people who take opioids for long enough will develop physical dependence and suffer withdrawal if the drugs are stopped abruptly, addiction in pain patients is rare.
“The reality is that addiction appears to be distinctly uncommon in patients without a prior history of addiction or a family history of addiction,” [Russell] Portenoy says. In his own research on more than 200 patients treated with OxyContin for chronic pain over three years, no new cases of addiction were reported.
“Over 30 years, I’ve seen a few thousand patients with cancer and sickle cell [disease] and other [conditions], and less than five that I’m aware of became addicted,” [Dr. Richard] Payne says.
Dr. Richard Payne is a professor of medicine and divinity at Duke University. Dr. Gavril Pasternak is a neurologist at Memorial Sloan-Kettering Cancer Center in New York City. Russell Portenoy is chair of Pain Medicine and Palliative Care at Beth Israel Medical Center in New York City. I hope this helps. For the whole article go to http://health.msn.com/health-topics/...0195150&page=1

[JJx23]

How about comparing the two thoroughly? Someone who uses pain medication for pain (Person 1), and someone who uses pain medication for recreational use (Person 2). Both are obviously taking the medication, so both of them are allowing the medication to bind to their receptors. Person 2 is taking the meds for fun, so that person would be overdoing it obviously. Person 1 is taking the meds for their pain, so they most-likely are taking the meds as prescribed.

The difference between the two are that one is under control, while the other is out of control. A druggie is not someone who is going to pop the pills as prescribed. It's probably a long-shot that the person who is hooked on the pills for fun is even getting them legally. Tolerance builds up when you take the pain pills for a long time, so obviously both people would probably go through some sort of withdrawal, but Person 2 would go through a much worst one, unless Person 1 was taking large doses of the medication as well.

Going back to a few posts in this thread. It would definitely be different if the pain that Person 1 was feeling isn't as bad anymore, seeing that it healed already, but when you stop taking pain medication right away, your pain will naturally be a bit worst than it normally is. This is a side-effect of withdrawal unfortunately, but any pain management doctor would wane a patient off of the pain medication, so they do not suffer all that much, if at all...

So the simple difference is that Person 1 is going to be quite fine, while Person 2 is going to go through hell, seeing that the person is a druggie. You can have a drug problem, but there are also people who have a pain problem who depend on their drugs to allow them to function day to day. That is the definition of chronic pain.

Hope this helps.

Regards.

[blackdb1]

Swim believes unless one comes to like the effects of an opiate/opioid and cannot gain satisfaction through regular, sober life they will soon return to 'normal'. After the initial withdrawals subside the person taking it strictly for pain management should not get any of the 'side effects' of addiction to opiates... However depression would most likely be an issue to deal with but most likely with physical activity and good nutrition should have that person back to their regular emotional state within a month dependiong on the length on said opiate.

This is only swims own personal opinion and it is not fact only his interpretation of what would happen in said circumstances.

[pixplzthx]

It's easy to say an addiction is an addiction. After all the kid with the 2 liter bottle of mountain dew crashes at the end of the day just like the middle aged worker at the end of a coffee pot.

However (comma) How do I word this... (?)

The kid around the corner has never taken an opiate, intentionally for recreational reasons. That doesn't mean that recreational effects aren't felt, it's just that the thought process behind the drug use is different.

Isn't that all we are really saying?

A person using a substance for chronic/acute pain will have a different view of that substance than someone whose reward mechanism is tied to that substance. Let's put that mouse in the cage shall we?

Mouse number one has had his poor tail broken by the scientist in order to measure a tail flick response to morphine. It is apparent that it is easy to "function" (lower level) for this mouse on the substance. The substance is regulated and monitored to ensure our lab mouse is getting the appropriate medicine for the need. Getting to the cheese and water is easier than it was without the morphine. Of course, it was a lot easier before the scientist broke the tail. Anyway, it has finally healed up and movement is restored. While physical withdrawls are precipitated, they are not inherently tied to the substance.

Unlike poor mouse number two. This mouse is given all the morphine it wants whether it "needs" it or not. But in this case the reward mechanism is tied to the substance. Hit the lever, get the dose and get the good feelings. Getting to and from the cheese are secondary to survival. When the morphine is withdrawn, there are factors at play that do not exist for the non-recreational mouse.

Our two mice simply illustrate a fundamental difference in their addictions. One mouse needed the substance to function on a basic level. The other mouse pursued the substance in disregard to basic well-being.

The mind/brain is a wonderful thing. I think it is smart enough to know the difference.

Reputation Comments on this post:

great poster

[OhCasey]

Originally Posted by pixplzthx

The kid around the corner has never taken an opiate, intentionally for recreational reasons. That doesn't mean that recreational effects aren't felt, it's just that the thought process behind the drug use is different.

We cant be entirely sure why some individuals become addicted and some dont but i think the thought process behind the use has alot to do with it. Some if not most doctors believe that a large % of people in pain recieve different effects from opioids then those who use recreationally.

I met an older guy who was a recovering alcoholic once, Friend of a family member. This man had been sober from all drugs and alcohol for over 10 years, excluding Coffee, Asprin and Cigarettes. While working he was involved in a bad accident that did some pretty bad damage to his back. He was on and off of the operating tables for almost a year. In that time he was on multiple opiates for the whole time. After the 12 or so months he stopped taking them, dont know if a taper was used but since they were prescribed im gonna say most likely it was. I remember him talking to my father at the time about how when he first was put on opiates at the hospital he almost freaked because he went through a 12 step program that said any drug use would cause him to relapse, they obviously make exceptions for prescribed medication for actual problems. He said once he talked to a counsler at the hospital he was calmed down and went through with opiate pain medication. I still know him and hes still sober after a prolonged period of high dose opiates and thats with being an alcoholic and having an enormous risk of building an addiction to opioids. Not everyone who uses opiates become addicted. Not everyone who uses them at high doses becomes addicted. Not everyone who uses them for long periods of time becomes addicted.

[JJx23]

The mind is an amazing thing, too bad it isn't completely figured out yet. We're close to it, but not totally there, there is just so much to learn.

Anyhow, I enjoyed reading your post.

Regards.

Originally Posted by pixplzthx

It's easy to say an addiction is an addiction. After all the kid with the 2 liter bottle of mountain dew crashes at the end of the day just like the middle aged worker at the end of a coffee pot.

However (comma) How do I word this... (?)

The kid around the corner has never taken an opiate, intentionally for recreational reasons. That doesn't mean that recreational effects aren't felt, it's just that the thought process behind the drug use is different.

Isn't that all we are really saying?

A person using a substance for chronic/acute pain will have a different view of that substance than someone whose reward mechanism is tied to that substance. Let's put that mouse in the cage shall we?

Mouse number one has had his poor tail broken by the scientist in order to measure a tail flick response to morphine. It is apparent that it is easy to "function" (lower level) for this mouse on the substance. The substance is regulated and monitored to ensure our lab mouse is getting the appropriate medicine for the need. Getting to the cheese and water is easier than it was without the morphine. Of course, it was a lot easier before the scientist broke the tail. Anyway, it has finally healed up and movement is restored. While physical withdrawls are precipitated, they are not inherently tied to the substance.

Unlike poor mouse number two. This mouse is given all the morphine it wants whether it "needs" it or not. But in this case the reward mechanism is tied to the substance. Hit the lever, get the dose and get the good feelings. Getting to and from the cheese are secondary to survival. When the morphine is withdrawn, there are factors at play that do not exist for the non-recreational mouse.

Our two mice simply illustrate a fundamental difference in their addictions. One mouse needed the substance to function on a basic level. The other mouse pursued the substance in disregard to basic well-being.

The mind/brain is a wonderful thing. I think it is smart enough to know the difference.

[UpAllNiteOCXTC]

one way swim would distinguish between person 1 and 2 is the dosage. person 1 is most likely receiving regulated doses from their physician, while person 2 is exceeding a typical dose, and using more frequently, therefore making it abuse.

having a physician administer the drug may possibly delay the addiction potential, but cant eliminate the inevitable.

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they cant read

[samuraigecko]

just ask your doctor.
even under pain management addiction is a real problem.
this is why any good pain management specialist will regularly re-assess a patient.
this is also why they use a weening regime.
one wonders if there are any other statistics you have looked at.
a fair number of pain management patients end up going far beyond the expected duration, not because they are still in pain but because they feel "phantom pain" as a result of withdrawal.

As one has said many times over, a fair number of patients may get off rather easily and be weened well and never even truly experience any noticeable withdrawal, if they have a good pain management specialist and a good PMP in place.

Unfortunately a fair amount of doctors and specialists can be rather sloppy with their work, one is sure that a fair number of people will agree there.

Those whom are on pain meds for a significant period of time and then are abruptly taken off will experience something totally different, any doctor will tell you this.

obviously both one and yourself and their respective doctors hold different opinions, which is fine, thats what the world is about. . . . different opinions.

lets leave it at that shall we.

[UpAllNiteOCXTC]

"Myth No. 6: Addiction is inevitable if opioids are taken long-term or in high doses—and the risk of addiction is very high for short term use."

For Swim, this was and still is 100% true. Sure, mentally swim wants it, and even at times craves it, but whatever. Before he died, Swim's boyfriend introduced her to the world of opiates. Which led to her using 80mg oxy's daily, and percocets/vicodin/xanax etc when oxys werent available.

After Swims boyfriend got killed, Swim did not have an opiate connection. She didn't want one either. They reminded her of her boyfriend. Swim did not seek opiates until about 7 months after he passed, and this was just for reminiscing, and recreation. Swim had no withdrawals, no physical pain, nothing!

Maybe this is because everyone has a different chemical makeup, but Swim believes she could go on those oxy binges again and not freak out when they're all gone.

[JJx23]

Well, we have a very good pain management office in my area. They wane everyone off of the drug, once the original doctor has said they are getting better, and then the pain management doctor re-assesses the patient, which is a great thing to do. I mean they do it every visit, which I think it great. Everytime I go to my pain doctor, I have to sign a load of papers, so we take it seriously here. My pain is very severe, and I can tell you that I just wish it would go away. I mean being on Percocet helps me do my work due to the pain, but living on pain meds isn't a way to go through life either.

Regards.

Originally Posted by samuraigecko

just ask your doctor.
even under pain management addiction is a real problem.
this is why any good pain management specialist will regularly re-assess a patient.
this is also why they use a weening regime.
one wonders if there are any other statistics you have looked at.
a fair number of pain management patients end up going far beyond the expected duration, not because they are still in pain but because they feel "phantom pain" as a result of withdrawal.

As one has said many times over, a fair number of patients may get off rather easily and be weened well and never even truly experience any noticeable withdrawal, if they have a good pain management specialist and a good PMP in place.

Unfortunately a fair amount of doctors and specialists can be rather sloppy with their work, one is sure that a fair number of people will agree there.

Those whom are on pain meds for a significant period of time and then are abruptly taken off will experience something totally different, any doctor will tell you this.

obviously both one and yourself and their respective doctors hold different opinions, which is fine, thats what the world is about. . . . different opinions.

lets leave it at that shall we.

[bloodred1889]

Originally Posted by JJx23

. I mean being on Percocet helps me do my work due to the pain, but living on pain meds isn't a way to go through life either.

swim totally agrees with this statment, even though we are talking about addiction
many people think if you take pain meds alot your a junkie/addict, when chroonic pain sufferers really have this same attituude, yes the pain meds help, but it would be great to just live without them.

bloodred1889 added 44 Minutes and 15 Seconds later...

heres one for gecko and oh casey.
ok so swims mother is a or was a heroin addict for many many years, when she was my age she would lye to the doctors to get opioids, or anything, her and friends would even brake into pharmacies to get drugs.
she even told swim that when she went to the doctors for drugs and they said no she would cry and beg, even though she was lying, the fact she really wanted the drugs became real and so the crying and need was real.

anyway so she has been on methadone for the past 10 years now, and no matter what she will always be an addict at heart.
she knows and has said she has an addictive personality.
swim(daughter of the above) also has an addictive personality, and we belive that it runs in families.
thus as ironic as it is swim gets a chronic condition were by she has to take opoids.
due to her addictive nature and the fact that opioid highs are very nice, she became addicted, and had bigger and bigger doses for a while untill she realised what she was doing and now only takes the prescribed amount, even though actually its not strong enough ect ect.

swim thinks with certain people becoming addicted to an opioid is gonna happen.

but in the case of swims boyfriend its very diffrent, he comes from a stern familiy who are anti drug, even though he has had drugs for fun, such as coke and stuff he actually dosnt get any effect from opioids atall, they do apsolutly nothing, he had to take them for a while and when they were stopped he didnt have any sign of withdrawel are desire for them again.

what swim is saying is... maybe its all to do with the person and how they grew up, what genes they have ect ect ect.

so you cant really say everyone who takes opioids will get addicted or they wont.