I’m taking a prescription drug for pain that says it can cause drug dependence and addiction. What’s the difference between these two things and how can I tell if I’m one or the other?

Pain relievers that contain opioid substances are called narcotics. An opioid is a chemical substance that has a morphine-like action in the body. Because law enforcement refers to any illegal drug as a narcotic, doctors prefer to use the term opioid for any medication that has opioid-like actions in the body.

Opioids reduce pain and give people a general sense of well-being. They feel high euphoric. Opioids reduce tension, anxiety, and aggression. But they can also cause tolerance, dependence and addiction.

Tolerance refers to the individual’s need for increased amounts of the substance to produce the same effect. Dependence refers to the increasing use of the drug to maintain the same level of pain control.

Dependence is a physiologic dependence on the substance. Withdrawal symptoms emerge when the drug is stopped abruptly. Once a medication is no longer needed, the dosage will have to be tapered down to avoid withdrawal symptoms.

Addiction refers to compulsive use of and craving for a substance or drug. With addiction there is a daily need for the substance in order to function. It also includes an inability to stop use as well as recurrent use when it is harmful physically, socially, and/or psychologically.

Addiction is based on physiologic changes associated with drug use. But there are also psychologic and behavioral components. Individuals who are addicted will use the substance to relieve psychologic symptoms even after physical pain or discomfort is gone.