By Christine Traxler, MD

Health Aug. 05, 2011 - 05:07AM JST ( 4 )

There are several medications out there that have addiction potential for the user with an addictive personality or who are on the medication for a long period of time. These include benzodiazepines and opioid medication, which are available by prescription. There really aren’t any addictive medications you can get over the counter so you can take these medications safely.

Addiction is a different thing from physical dependence or tolerance. The tolerance to medication occurs when a person needs to take more of a medication to get the same effect as before. It is a natural phenomenon in benzodiazepine and opioid use and must be taken into account when the doctor prescribes these medications. Physical dependence is when a person has developed a need to have the medication over and over again because of a physical need to have the medication. If they don’t get the medication, they suffer from withdrawal symptoms, which is a natural process when stopping an addictive medication.

Medication addiction is part physical dependence and part emotional dependence on a medication. The person takes more medication than is prescribed and exhibit behaviors that are designed to get more medication, even when it is no longer physically needed. Technically, there can be addiction without actual physical dependence and physical dependence without addiction.

Opioid addiction is very common. This is a class of medications for which physical dependence and tolerance are very common. Under medical supervision, however, the risk of addiction is small; especially when the physician is aware of how much the person is taking and can assess how much the individual really needs. Prolonged prescribing of large amounts of opioids can definitely trigger an addiction potential.

Opioids that are addictive include codeine, morphine (MS Contin), Oxycontin or oxycodone, meperidine, which is Demerol and hydrocodone, which is Vicodin. Risk factors for addiction include those people who take more medication than is prescribed and who take the medication when they are not even in pain. These are people who have a history of other addictions, such as to alcohol, or who have previous addiction to narcotics.
Benzodiazepines are less addictive than opioids but still have a strong addiction potential. Benzodiazepines are used to treat anxiety conditions; some people become addicted to the medication and feel anxious all the time, in spite of taking the medications. They also take the medication when they don’t have anxiety symptoms. The side effects of taking benzodiazepines are fatigue, feeling calmer and having difficulty safely driving a car or using heavy equipment due to fatigue, lack of concentration or dizziness.

So how is addiction prevented? The individual taking the medication must take the medication as prescribed by the doctor and must not take more than prescribed. Tell your doctor if you have a history of addiction to other drugs in the past, including alcohol. You should not take the medications if you have no symptoms and you should tell your doctor about any withdrawal symptoms you experience when not taking the medication. Physical dependence to medication can be managed by carefully tapering off the medication so that physical dependence does not occur. Tolerance is normal and this just means that tapering off the medication will need to be a slower process.

It is vital that you tell your doctor if you think you are becoming addicted. A good doctor will not stop the medication altogether and will help you taper gently off the medication to a smaller dose or to a different, non-addicting medication for your anxiety or pain. 

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