Many of the concerns regarding opioid use originate from misconceptions or confusion regarding the terminology describing the risks of addiction, tolerance, and dependence. Numerous authorities ? including the American Academy of Pain Medicine, American Pain Society, and the American Society of Addiction Medicine ? have addressed these concerns. An appreciation of more concise definitions can help dispel misunderstandings, which otherwise might lead to inadequate pain management therapy.

To help clarify this question a consensus document was developed by the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine in 2004. They have agreed upon the following definitions for addiction, physical dependence, tolerance, and pseudoaddiction. For a more in-depth explanation you can go to Chapter One in Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management? System.

Opioid dependence is more common than you may think. Opioid dependence is not predictable—it is a reaction that occurs in people who, for reasons that are not completely understood, are biologically and psychosocially vulnerable. Men and women of all ages, races, ethnic groups, and educational levels can become dependent on opioids.

Opioid dependence is best understood as a chronic disease caused by fundamental changes to brain structure and functioning, the result of which is compulsive opioid use.1,2 Chronic opioid use is a precursor to the brain changes characteristic of opioid dependence, but it is only one of the etiologic factors in the development of the disease.2,3 Chronic opioid use alone does not cause opioid dependence.

SUBOXONE treatment is usually broken down into 6 phases, but only 4 of those involve the pharmacist: induction, stabilization, maintenance, and medically supervised withdrawal. Induction: The goal of induction is to safely suppress opioid withdrawal as rapidly as possible with adequate doses of SUBOXONE. Patients cannot begin their induction to SUBOXONE (and off of their previous opioid) until they are experiencing mild-to-moderate withdrawal symptoms.

Buprenorphine has been available as SUBOXONE in the United States since 2003. In Europe, buprenorphine was introduced during the mid-90s. Today, more than 400,000 opioid-dependent patients worldwide have been treated with buprenorphine. All opioids can cause physical dependence. SUBOXONE belongs to a class of opioids called "partial opioid agonists.

A diagnosis of opioid dependence is based on the DSM-IV Criteria for Substance-Related Disorders.

The difference between abuse and addiction or dependence has to do with the degree of compulsion in the drug use. When someone spends most of the time getting, using or thinking about the drug; when he or she disregards all health consequences; when, after withdrawal, the person is compelled to use again because the psychoactive substance is still the most important thing in life, then that's addiction. Dependence and withdrawal can be both physical and/or psychological.

SUBOXONE has been proven effective for suppressing opioid withdrawal symptoms, decreasing opioid cravings, and improving treatment retention.5,6 SUBOXONE is also the first opioid approved under DATA 2000 for the office-based treatment of opioid dependence. Office-based treatment is important because of its potential to enhance the privacy of treatment as well as patients' access to care.

For the past 40 years there have been only a few treatments; abstinence, cold turkey, replacement therapy and medical detox. -MORE-

Cocaine is a highly addictive drug. It works in the same way as heroin and nicotine by tapping in the brain's natural reward (dopamine) pathways. You experience pleasure every time you take it and a distinct lack of pleasure once it wears of, thus reinforcing the compulsion to take more. And more. And more.Cocaine is a captivating drug that makes you feel confident, talkative, alert, quite a draw for those who find it difficult to feel that way normally.

Many family members wonder why doctors use buprenorphine to treat opioid dependence, since it is in the same family as heroin. Some of them ask, "Isn't this substituting one addiction for another?" But the two medications used to treat opioid dependence-methadone and buprenorphine-are not "just substitution.

The full text of DATA 2000, including all language describing physician qualifications, training criteria, and the physician-waiver process can be found at buprenorphine.samhsa.gov or by contacting SAMHSA directly: Information about treating opioid dependence, including patient management, preparing your practice, creating a referral network, and more is available in the Practice Management Tool Kit.

A tolerance to alcohol and a dependence on alcohol are very different things. When someone develops a tolerance to alcohol, it means they will have to consume more alcohol to feel the same effects that they used to have with lower amounts of alcohol. Anyone can develop a tolerance for alcohol. When someone develops a dependence on alcohol, they often feel as though they need alcohol and find it very difficult to stop or reduce drinking.

How does it begin and when does a pattern of behavior become an addiction? Some individuals seem to have the expertise to use a substance or engage in a behavior periodically over a period of years without becoming 'hooked.' Others; however are not capable of stopping and become addicted. The causes of addiction have been studied for several years. In bountious ways, addiction is caused by the emotion the substance or behavior brings about in the user.

Doctors in each State who have waivers to prescribe buprenorphine for the treatment of opioid addiction are listed on the SAMHSA Buprenorphine Physician Locator Web site. Prescription pain relievers like oxycodone and codeine are opioids. Buprenorphine is used to treat addiction to opioids. Buprenorphine prevents withdrawal symptoms so that a person can stop taking the opioid drug to which he or she is addicted.

In addition to this Web site, you can visit the FDA's buprenorphine pages at http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm Additionally, you can contact the SAMHSA Buprenorphine Information Center by telephone, toll-free at 1-866-BUP-CSAT (1-866-287-2728), or by e-mail at info@buprenorphine.samhsa.gov. Yes. Physicians employed by an agency of the Federal Government are eligible for DATA 2000 waivers.

Office of National Drug Control Policy (ONDCP), there were an estimated 810,000 to 1,000,000 individuals addicted to heroin in the US in the year 2000.... -MORE-