Pseudoaddiction: How It May Affect Treatment - Medical News Today

Maybe your like

Medical News TodaySubscribeWhat to know about pseudoaddiction

Medically reviewed by Karin Gepp, PsyD — Written by Jennifer Huizen — Updated on March 3, 2023

Is it common?
Causes
Signs and symptoms
Vs. addiction
Treatment
Contacting a doctor
Summary

Pseudoaddiction can resemble drug addiction, as it involves substance misuse and attempts to obtain drugs. It can happen when people are not getting appropriate treatment for their pain. It is not an official diagnosis.

People first used the term pseudoaddiction in 1989 to describe a phenomenon that can occur in people with untreated or under-treated pain. Pseudoaddiction affects people with legitimate pain that pain medications such as opioids could help treat. It occurs either when they do not receive a prescription for proper pain medications or when the prescribed dosage of these medications is too low to manage their pain.

When people have chronic or severe pain that they cannot manage properly with their current prescription, they may misuse substances in an effort to reduce their pain. A healthcare professional may misinterpret substance misuse in people with pseudoaddiction as signs of an addiction.

As the term pseudoaddiction is not a diagnostic term in itself, its use may actually increase bias toward those who live with pain.

Keep reading to learn more about pseudoaddiction, including the causes, symptoms, and how to treat and manage the condition.

Is it common?

Pills in shadow as to represent pseudo addiction — Fredy Sanchez/Getty Images

According to the Centers for Disease Control and Prevention (CDC), in 2019, some 20.4% of adults in the United States were living with chronic pain.

The percentage of people with untreated or poorly managed pain is unknown, but an estimated 83% of the global population have inadequate or no access to appropriate pain management medications.

It seems likely that a large proportion of people without access to pain medications or proper pain management will employ other methods, such as substance use, to reduce their pain. According to estimates, chronic noncancer-related pain affects about 48–60% of people who use drugs compared with 11–19% of the general population.

Causes

Untreated or poorly managed pain causes pseudoaddiction. The reasons as to why someone is not receiving adequate treatment is a more complex issue.

Many people globally do not have proper access, or any access, to pain medications or management. In some parts of the world, the resources to obtain or keep an adequate supply of appropriate pain medications are lacking. In other cases, people might not be able to afford pain medications or access healthcare professionals who prescribe them.

The stigma associated with certain pain medications, such as opioids, may also prevent someone from talking with a doctor about them or using them.

Signs and symptoms

The signs and symptoms of pseudoaddiction tend to mimic those of addiction or conditions linked with addiction — in particular, opioid use disorder.

Common signs and symptoms of opioid use disorder and other types of substance addiction include:

a strong desire or craving to use opioids or other substances
taking more of a drug than the prescribed amount or taking it for longer than intended
spending a significant amount of time getting or using the drugs or recovering from the effects they cause
taking desperate or unsafe measures to obtain opioids or other substances
having problems meeting obligations at home, school, or work
using opioids or substances despite experiencing recurring interpersonal, social, or work issues as a result
reducing regular activities or giving them up because of substance use
using opioids or other substances in situations that could result in physical harm or danger to others
requiring increased amounts of the drugs to achieve the desired effect
undergoing withdrawal or taking opioids or other substances to avoid or reduce symptoms of withdrawal

Pseudoaddiction vs. addiction

It is possible to distinguish pseudoaddiction from true addiction if someone’s symptoms resolve once they receive proper treatment. However, currently, there is not enough scientific evidence to support pseudoaddiction as a separate diagnosis from addiction.

Can pseudoaddiction become addiction?

There is not much research or even anecdotal evidence regarding whether pseudoaddiction can become a true addiction. However, misusing prescription drugs or other substances, as some people with pseudoaddiction do, can cause addiction.

During the first 5 years after chronic pain develops, someone has a higher risk of developing new or unrelated substance use problems. This is particularly true for people with a history of substance use disorders.

People taking opioids for an extended period also have a much higher risk than others of misusing the medication or using illegal drugs. About 50% of people on long-term opioid therapy misuse the drug at some point, and the rates are even higher among people with a history of substance use disorders.

Some other factors can also influence the risk of someone becoming addicted to prescribed medications. These include:

levels of emotional distress
disability
concerns about addiction
excessive scrutiny from others about medication use

Treatment and management of pseudoaddiction

The best way to manage and treat pseudoaddiction typically involves adequate pain control, most commonly in the form of prescription opioid medications to achieve an analgesic, or pain numbing, effect. Someone already taking opioid medications whose pain is still not under control may need to take higher or more frequent doses under the direction of a doctor.

People who are already taking opioid medications should review the possible negative effects of staying on the medication with their prescribing doctor to ensure that the benefits outweigh the risks. If someone decides that they need to stop taking pain medications, they should seek the advice of a doctor on ways to taper off the medications safely to minimize the impact of withdrawal symptoms.

People tapering off pain medications may benefit from support in the form of psychotherapy and other medications. The same is true for people who are attempting to reduce or stop medication misuse.

When to contact a doctor

People with untreated or under-treated pain should talk with a doctor about ways to reduce or manage their pain.

Without proper treatment, moderate to severe pain can cause, contribute to, or increase the risk of:

high blood pressure
high cholesterol or blood lipid levels
adrenal exhaustion
cardiovascular collapse
problems maintaining employment, social relationships, or daily obligations
feelings of hopelessness
sleeping problems
depression
anxiety
reduced quality of life
homelessness and poverty
suicide

Summary

Pseudoaddiction is a term that describes when someone with untreated or improperly managed pain displays substance misuse in a way that mimics addiction.

Pseudoaddiction is not a separate diagnosis from addiction.

People with untreated pain or pain that their prescribed medication does not manage should speak with a doctor about their options.

Mental Health
Alcohol / Addiction / Illegal Drugs
Psychology / Psychiatry

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Canadian Pain Task Force report: June 2019. (2019). https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2019.html
Levenson, J. L. (2019). The American Psychiatric Association Publishing Textbook of Psychosomatic Medicine and Consultation-Liaison Psychiatry, Third Edition.https://books.google.ca/books?id=-WZnDwAAQBAJ&pg=PA1109&lpg=PA1109&dq=pseudoaddiction+APA&source=bl&ots=5esIBRAUXe&sig=ACfU3U0_oMTdrP7yd6w4czOXMrNt2-73aA&hl=en&sa=X&ved=2ahUKEwjTn-D258X2AhVJbc0KHQyGDYMQ6AF6BAgfEAM#v=onepage&q=pseudoaddiction%20APA&f=false
Opioid use disorder. (2018). https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder
Priya, L., et al. (2021). Opioid pseudoaddiction in a patient with long-term oxycodone use for chronic pain. https://scholars.direct/Articles/anesthesia-and-pain-management/jcapm-5-039.php?jid=anesthesia-and-pain-management
Quinlan, J., et al. (2017). Acute pain management in patients with drug dependence syndrome. https://journals.lww.com/painrpts/fulltext/2017/08000/acute_pain_management_in_patients_with_drug.10.aspx
Tennant, F. (2017). United Nations says untreated pain is "inhumane and cruel." https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/united-nations-says-untreated-pain-inhumane-cruel
The science of drug use and addiction: The basics. (n.d.).https://archives.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics
Voon, P., et al. (2018). Pain as a risk factor for substance use: A qualitative study of people who use drugs in British Columbia, Canada. https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-018-0241-y
What is a substance use disorder? (2020). https://www.psychiatry.org/patients-families/addiction/what-is-addiction
Yamaguchi, S. (2021). SY3-4 Chemical coping and pseudo addiction in cancer patients [Abstract]. https://www.annalsofoncology.org/article/S0923-7534(21)01621-5/fulltext
Zelaya, C. E., et al. (2020). Chronic pain and high-impact chronic pain among U.S. adults, 2019.https://www.cdc.gov/nchs/products/databriefs/db390.htm

Share this article

Medically reviewed by Karin Gepp, PsyD — Written by Jennifer Huizen — Updated on March 3, 2023

Latest news

To keep your heart healthy, try drinking more orange juice
Eating kimchi daily for 12 weeks may help regulate immune system
Supplement mix helps reduce tumor aggressiveness in deadly brain cancer
6 depression symptoms in midlife linked to almost 50% higher dementia risk
Eating more ultra-processed foods linked to higher Crohn's disease risk

Related Coverage

What is the difference between opiates and opioids?Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP
This article explores what opioids and opiates are, the difference between them, and how people can seek help for addiction and overdose
READ MORE
What is addiction?Medically reviewed by Alyssa Peckham, PharmD, BCPP
Addiction is a condition in which a person is unable to stop using a substance or engaging in a behavior. Read on to learn more.
READ MORE
What are CBD patches for pain?Medically reviewed by Eloise Theisen, RN, MSN, AGPCNP-BC
CBD patches are transdermal patches containing cannabidiol (CBD). They slowly release CBD into the bloodstream through the skin. Learn about their…
READ MORE
What happens when you sleep high?
What impact can cannabis have on sleep? Read on to learn more about the influence cannabis can have on sleep and whether it can improve sleep quality.
READ MORE
What is boofing, and how can a person do it safely?
What does the term boofing mean, and why do people do it? Read on to learn more about this method of drug use and tips to do it safely.
READ MORE

Tag » What Is Pseudo Addiction Mean

Pseudoaddiction: How It May Affect Treatment - Medical News Today

Health Conditions

Health Products

News

Original Series

Podcasts

General Health

Health Tools

Quizzes

About Medical News Today

Find Community

Follow Us

Is it common?

Causes

Signs and symptoms

Pseudoaddiction vs. addiction

Can pseudoaddiction become addiction?

Treatment and management of pseudoaddiction

When to contact a doctor

Summary

How we reviewed this article:

Latest news

Related Coverage

Pseudoaddiction: Fact Or Fiction? An Investigation Of The Medical ...

What's The Difference Between Addiction And Pseudo-addiction?

Pseudoaddiction | Origins Behavioral Healthcare

What Is 'Pseudo-addiction?' - Drug Addiction - Medic8

What Is Pseudoaddiction (Is It Real?) - Addiction Group

Pseudoaddiction - Wiktionary

Chronic Opioid Treatment, Addiction And Pseudo ... - Psychiatric Times

What Is Pseudo-addiction - Meaning And Definition - Pallipedia

What Is Pseudoaddiction? | Vertava Health Blog

Definition Of Pseudoaddiction By Medical Dictionary

Pseudo Addiction Definition | Law Insider

What Is Pseudoaddiction - Redondo Beach Drug Rehab

Opioid Pseudoaddiction In A Patient With Long-Term Oxycodone ...

Opioid “pseudo-addiction” Lives Up To Crime Of The Century Tag | InSight+

Contact