The real dangers of equating opioid dependence with addiction

(l-r) Dr. Susan Glod, Associate Professor of Medicine, Palliative Medicine Center of Excellence at Penn State; Dr. Diana Fishbein, Director, Translational Prevention Research, FPG Child Development Institute, University of North Carolina & Senior Research Faculty at Penn State; Dr. Nora Volkow, Director, National Institute on Drug Abuse; Dr. Brendan Saloner, Associate Professor, Johns Hopkins Bloomberg School of Public Health; Dr. Phillip Graham, Director, Center on Social Determinants, Risk Behaviors, and Prevention Science, RTI International; Dr. Patrick Byrne, Post-Doctoral Fellow, University of Texas at Austin

Diana Fishbein, Penn State research professor in human development and family studies, recently organized a Congressional briefing with the National Prevention Science Coalition to Improve Lives and the Congressional Addiction, Treatment and Recovery Caucus, to discuss the important distinctions between addiction and dependence in developing policy responses to the opioid epidemic. Although many people conflate addiction and dependence, they are not the same, and the distinction has important implications for the millions of people who rely on opioid medications for pain management.

This briefing brought together lawmakers, regulators, physicians and other scientists, and the public into this critical conversation. Speakers addressed the science of addiction and dependence, how the distinction between them affects clinical practice and policy, and specific strategies suggested by the medical and prevention sciences for ensuring that patients’ differential needs are met. The latter includes:

  1. a public health campaign to educate the public, lawmakers, industry leaders and community organizations about the distinction between dependence and addiction and its policy implications;
  2. de-stigmatizing appropriate medical use of opioids to ensure patients receive needed treatments;
  3. routinely implementing assessments to distinguish patients with addiction from those with dependence to appropriately guide remedies; and
  4. scaling up evidence-based individual, family, school and community-level preventive interventions and policies to reduce exposure to the detrimental conditions that lead to addiction (Prevention and Intervention). 

Although prescribing and monitoring are largely a physician-based undertaking, state and federal governments play a role in providing regulatory oversight and legislative guidance that support the evidence-based initiatives needed.

View videos from the policy briefing.

People Mentioned in this Article

Diana Fishbein