Frequently Asked Questions

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MisuseThe use of a medication other than as indicated by a physician whether or not it is done intentionally. is the improper use of a drug.  This may include taking an amount different than prescribed, early cessation of a prescribed drug outside the advice of a physician, or taking another person's prescription drugs

Abuse is the improper use of a legal drug for nonmedical reasons, or using an illegal drug.

Physiological dependence is a condition in which a patient's body adapts to the use of a drug. Physiological symptoms of withdrawalA part of physical dependence that occurs when a medication is stopped quickly or reduced too rapidly with symptoms that include sweating, anxiety, restlessness, insomnia, dilated pupils, chills, high blood pressure, nausea/vomiting, abdominal pains, diarrhea, and muscle aches may be expected if the medication is stopped suddenly. ToleranceA condition in which continually taking a medication causes a decrease of the medication's effects. may also be a part of physical dependenceA condition characterized by withdrawal symptoms brought about when the medication is stopped too quickly, its dose is reduced too much, its presence in the blood continually decreases, and/or certain other drugs are taken that block the medication.. Tolerance occurs when a person's body becomes adapted to a drug. The same dose does not continue to provide the same amount of pain relief, and may need to be increased to provide the same effect. Physiological dependence sometimes occurs with chronic opioid therapyDaily (or almost daily) use of opioids for at least 90 days. for pain.

is a maladaptive condition that may or may not include physical dependence. It is characterized by signs of psychological dependenceThe use of a substance to obtain relief from emotional discomfort rather than being associated with tolerance or withdrawal. that interfere with a person's quality of life and functioning.

Substance Dependence is what the diagnosis manual (DSM) of the American Psychiatric Association calls addiction. It is a psychological disease that often includes signs of physiological dependence. It is associated with compulsive and often harmful continued use of a drug despite adverse consequences. People who have physiological dependence do not necessarily have Substance Dependence, that is, are not necessarily addicted.

A treatment agreement is an understanding between physician and patient of the upcoming treatment plan that aims to promote therapeutic adherence and enhance the physician-patient relationship; previously referred to as a patient “contract.” Recent guidelines from the APSAmerican Pain Society./AAPMAmerican Association of Pain Medicine. refer to these agreements as "Opioid Management Plans." It is not mandated by law but many specialists recommend a written agreement be used with all chronic pain patients on controlled substances. Physicians may choose to combine this written agreement with the informed consent document.

Informed consent is mandated by laws at both the federal and state level. Its components include goals/purpose of treatment, potential benefits and risks, special issues, and alternative treatment(s).

The use of medications, originally prescribed to treat pain, to help cope with stress or manage mood. It does not necessarily mean the patient is addicted.