What is Pseudo-Addiction?

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If you haven’t heard of the term pseudo-addiction before, you are not alone. As far as medical terminology goes, it was created relatively recently (in the late 1980s), and its use is still limited. However, even though it is a somewhat uncommon term, pseudo-addiction may be a significant concern — especially among people who are struggling with acute or chronic pain.

What is Pseudo-Addiction? 

According to an October 2015 article in the journal Current Addiction Reports, the term pseudo-addiction originated with the case of a 17-year-old patient who had leukemia. A few days after the patient began receiving morphine for pain associated with this disease, he began to exhibit the following behaviors that medical professionals often associate with opioid addiction:

  • He asked for medication before he was scheduled for his next dose.
  • He requested specific types of opioids
  • He engaged in “pain behaviors” (which the authors of the study described as crying, moaning, and complaining as a means of encouraging medical personnel to provide opioids)

David E. Weissman and J. David Haddox, who authored a study about this patient’s case, attributed the patient’s distress not to the improper use of opioids, but rather to the withholding of this medication by the members of their treatment team. 

Weissman’s and Haddox’s definition of pseudo-addiction notes that it is an iatrogenic syndrome that typically progresses through three phases:

  1. Inadequate use of analgesics (pain medications) to meet the patient’s needs
  2. Escalation of the patient’s demands, including behavioral changes to convince their treatment team that they are experiencing severe pain
  3. Crisis of mistrust between the patient and the members of their treatment team.

In their 2015 Current Addiction Reports article, authors Marion S. Greene and R. Andrew Chambers reported that pseudo-addiction is usually differentiated from traditional addiction by the patient’s motivation for requesting analgesic medications. 

If patients ask for opioids or similar drugs to alleviate pain, Green and Chambers wrote, they are said to have developed pseudo-addiction. If they do so to ease drug cravings or prevent the onset of withdrawal symptoms, they are defined as having a substance use disorder (addiction).

Signs & Symptoms of Pseudo-Addiction

Determining if someone has pseudo-addiction or if they have become addicted to prescription painkillers can be extremely difficult, even for experienced healthcare providers. One reason for this is that the signs and symptoms of pseudo-addiction can be virtually indistinguishable from those of addictions to opioids or other analgesics.

For example, the following symptoms could be signs of either pseudo-addiction or a substance use disorder:

  • Intense urges for a prescription painkiller
  • Wanting to use a prescription painkiller in larger amounts, or for a longer period of time, than directed by the prescribing physician
  • Spending considerable amount of time thinking about acquiring and using a prescription painkiller
  • Exhibiting physical and/or emotional distress when unable to acquire and use a prescription painkiller

As Green and Chambers wrote in Current Addiction Reports, the primary identifier of pseudo-addiction is the type of urge that prompts an individual to engage in drug-seeking behaviors. If that urge is related to a desire to alleviate acute or chronic physical pain, the person may have pseudo-addiction. 

This woman is showing the signs and symptoms of a pseudo addiction

Dangers of Pseudo-Addiction 

Here are two general dangers of pseudo-addiction: 

  • Continued failure to experience pain relief
  • The development of a substance use disorder 

Each of these dangers can, in turn, lead to a host of additional problematic outcomes.

For example, when someone doesn’t get proper medical care for serious concerns such as acute or chronic pain, they may find themselves at risk for other negative effects, such as:

  • Declining mental health
  • Worsening physical health
  • Inability to perform to their full potential in school or at work
  • Academic setbacks, job loss, and unemployment
  • Financial difficulties
  • Diminished self-confidence and self-esteem
  • Substance abuse
  • Pervasive sense of hopelessness
  • Suicidal ideation

In the absence of appropriate medical treatment for pain, a person may feel compelled to turn to alcohol or other illicit substances as a means of easing their suffering. This can quickly lead to addiction, which can increase the likelihood that a person will also experience the following:

  • Strained or ruined relationships with family members and friends
  • Separation, divorce, and loss of child custody
  • Inability to find and keep a job
  • Development of anxiety, depression, or another mental health disorder
  • Cognitive impairments
  • Organ damage
  • Heightened risk for HIV/AIDS, hepatitis, and certain cancers
  • Being arrested or incarcerated 
  • Overdose
  • Death

How Can Pseudo-Addiction be Treated?

As we alluded to earlier in this post, pseudo-addiction is a symptom, not a disorder. People who are defined as having pseudo-addiction may have mistakenly been identified as seeking drugs for illicit reasons, but they were actually trying to get proper care for an actual medical concern.

To eradicate pseudo-addiction, medical professionals need to do a better job of separating legitimate pain patients from people who are attempting to acquire opioids or similar medications for recreational purposes. Until this occurs, though, people who exhibit pseudo-addiction are at risk of developing mental health challenges and/or struggling with a substance use disorder. Thankfully, these are treatable conditions.

When pseudo-addiction leads to mental illness and/or substance use concerns, a person’s path to improved health may include one or more of the following levels of care:

Within these various levels of care, a person’s treatment may include elements such as the following:

Begin Treatment for Pseudo-Addiction at Renewal Health Group

If you have been struggling with overwhelming urges to use opioids or other prescription painkillers, Renewal Health Group can help. The treatment facilities in our network offer multiple levels of personalized care to help you overcome your compulsions and regain control of your thoughts and actions. For additional information or to schedule a free assessment, please visit our Contact Us page or call us today.

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