As an addiction medicine physician and because of the current opioid crisis facing our nation, I’m often asked, “Why do some people become addicted to opioids while others don’t?"
Before I answer that, let’s first review what opioids are. Simply put, opioids include prescriptions like codeine, hydrocodone (Vicodin, Norco) or oxycodone (Oxycontin, Percocet), but they can also be illegal street drugs, including heroin. You can learn more about what opioids are in this blog post.
The answer to why some people become addicted and not others is quite simple: Addiction is a disease that some people have and others don’t, just like any other disease. It’s estimated that about 10-15 percent of our population are actively battling addiction or recovering from it.
If you don’t have it, it’s very unlikely you’ll form an addiction to opioids or any other addictive substance or behaviors. (However, it’s worth noting that it is possible for anyone, regardless of whether or not you have the disease, to become physically dependent on opioids, but that is different than addiction.)
So, how does one develop addiction? The disease is in a person’s genes. The makeup of the responsible gene(s) affects the receptors—the circuits and wires, in other words—in the person’s brain that cause him or her to react differently to addictive substances than a person without the disease. But beyond that, we—doctors and researchers—don’t know much about the cause.
For a person with addiction, the disease is always present but only apparent when coupled with substance abuse or addictive behaviors. Currently, we don’t have a way to determine who has the disease and who doesn’t before a person shows symptoms of addiction. There are no blood tests or scans that we can run, but I hope and believe we will be able to do so someday.
Until then, I offer this advice:
Knowing your family history, and being aware and honest about the way opioids make you feel, can play an enormous role in whether or not addiction becomes a problem.
If you have concerns about opioid use or addiction, talk to your doctor, or make an appointment with me by calling 612-273-6099.