Five misconceptions of opiates

The opioid epidemic has ravaged our communities and is a growing national concern.

Despite this issue, opioids do have clinical benefits if used correctly by people who really need them.

While health care organizations are finding ways to combat the crisis, here are five misconceptions about opiates.

1. Opiates are addictive and should never be used

There is a misconception that opiates create physical dependence and eventually addiction. When used properly, opiates can be an important part of a medical care plan. It is important to remember that there is a distinction between physical dependence and addiction. Physical dependence is characterized by tolerance and withdrawal. Tolerance refers to the need to take more of a substance to receive the same effect. The truth is, after some time passes, you may need to take more opiates to get the same effect or pain relief. The increase is not a sign of addiction and when properly monitored is not a cause for alarm.

2. The experience of withdrawal

Withdrawal refers to the experiencing uncomfortable physical symptoms when abruptly ceasing a medication. Individuals who have taken opiates for more than a few days may need to be tapered off their medication over a period of time to avoid experiencing withdrawal symptoms. Usually the physician will decrease dosage over several days or weeks. Should you experience the effects of withdrawal (nausea, vomiting, chills) understand that while they may be unpleasant, they are not life-threatening. They are also not indicative of an addiction.

3. Addiction

Addiction is characterized by intense craving, an obsessive preoccupation with getting and taking a drug, and compulsive use even in the face of negative consequences. While tolerance and withdrawal are predictable symptoms that occur in the extended use of an opiate to treat pain, addiction is not. Most individuals who receive opiates to treat pain do not develop addiction. Similarly, physical dependence on opiates can be predictably managed in a time-limited period of days to weeks. By contrast, once someone is addicted to opiates, the addiction can be resistant to treatment and may extend for months or even years.

4. Those affected

The opioid crisis isn’t confined to a specific class, ethnicity or culture. It crosses all lines and affects every section of society. Our programs help those who are addicted and are purposely designed to appeal to a diverse population from the medically indigent and uninsured to commercial and privately insured patients, from those who are poor to those who are in the upper and middle class. Addiction does not discriminate.

5. Patient education

Prescription overdose deaths are sentinel or unanticipated deaths. Many stories in the press focus on heroin or illegal street drugs as being responsible for overdose fatalities. While heroin and fentanyl are part of the problem — 37 percent of overdose deaths come from misuse of opiate prescription medication as compared to 19 percent from illegal drugs — it’s important for physicians to educate patients about the proper use of prescription drugs, their side effects and how to properly dispose of the medicine when they are done. More kids gain access to unused prescriptions from their parents and friends who don’t properly discard of their medicine. Sharing medicine is increasingly problematic and drug take back and safe disposal programs have never been more important to help curb the epidemic.

Jonathan Morgenstern, PhD, is a professor of psychiatry at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health's assistant vice president for addiction services and director of the Center for Addiction Services and Personalized Interventions Research (CASPIR). An internationally recognized expert on the treatment of substance use disorders, Dr. Morgenstern is also a senior scientist at National Center of Addiction and Substance Abuse (CASA).


Featured in the following publications:

Spotlight on the opioid crisis 2017