Tolerance

Drug tolerance is basically the body's ability to adapt to the presence of a drug. When narcotic substances are taken regularly for a length of time, the body does not respond to them as well. Tolerance then becomes defined as a state of progressively decreased responsiveness to a drug as a result of which a larger dose of the drug is needed to achieve the effect originally obtained by a smaller dose.

Dependence or Addiction

There is a difference between dependence and addiction. Dependence occurs when tolerance builds up and the body needs the drug in order to function. Withdrawal symptoms will begin if the drug is stopped abruptly. On the other hand, when a person turns to the regular use of a drug to satisfy emotional, and psychological needs, they are addicted to that substance. Physical dependence exists as well, but the drug has become a way to cope with (or avoid) all kinds of uncomfortable feelings.

Many prescription drug addicts do begin by needing the drug they are prescribed for medical reasons. Somewhere along the line, however, the drug begins to take over their lives and becomes more important than anything else. Nothing will stop them from getting their drug of choice.

It may be difficult to understand how someone could let this happen. How could someone who is reasonably intelligent and sophisticated in regards to drug addiction become an addict? Addiction has nothing to do with intelligence. And addiction to prescription drugs is no different than any other substance abuse problem. Many people in the medical profession abuse prescription drugs. Health care providers may have a slightly higher rate of addiction due to both the stressful nature of the work and their relatively easy access to supplies of narcotics. Clearly, the potential risks and dangers involved with taking narcotics are not unknown among health care providers. This, however, doesn’t stop someone from becoming an addict. Some 12-step members have described addiction as a disease of the emotions.

Addictive Behaviors

Along with addiction, there are addictive behaviors that are quite common among addicts. Lying, keeping secrets, hiding pills and obsessively counting them, making unnecessary emergency room visits and constantly "doctor shopping." As the addiction escalates, engaging in such illegal activities as stealing prescription pads, committing forgery, and buying drugs off the street is also quite common behavior.

These behaviors usually stem from the desperation an addict feels regarding getting, securing, and taking their drug of choice. Under other circumstances, the individual would probably not engage in the behaviors listed above, unless they were previously part of his/her personality structure. In other words, addictive behaviors are limited to the addiction itself and are generally dissonant with the person’s beliefs and values in any other area of their life.

Paul

Paul* is a 29 year old advertising executive who was first prescribed medication for a relatively minor neck injury caused by a car accident. While hospitalized he was first treated with morphine and then was switched to Percocet. He left the hospital with a prescription for a week’s supply of pills.

The pills took away Paul’s pain. They made him feel calm and a little distant from his emotional pain, as well. Paul welcomed the relief from the emotional pain he was going through following the break-up of a serious relationship. It seemed to him the pills made him feel less lonely and needy. In addition, he found that the pills allowed him to feel more confident at work; he got more done, felt less stressed, and believed he functioned better.

Paul was upset when he finished his prescription. He called his doctor, telling her that he was still in pain. She prescribed more Percocet. She also let him know that if t