The Doctor’s Role in Chemical Dependency

Many patients fear – and reject – prescription drugs with the potential for addiction. Although very few develop dependencies on medications, it’s easy to wonder why doctors prescribe so readily.

Balance of Responsibility

There are actions physicians can take to minimize the addiction risk for their patients who take powerful painkillers or other addictive medications. Responsible physicians will prescribe addictive substances with discretion, make sure that their patients are aware of the potential for addiction, and instruct their patients about using their medication responsibly.

Patients have an equal responsibility to themselves and to their health care providers to seek and use medication responsibly. Addictive medications that are used properly and only when necessary will very rarely result in a chemical dependency. When patients administer medications in ways that were not intended, or in higher dosages than they were prescribed, the chance of addiction increases significantly.

Deconstructing a Dependency

A chemical dependency to a medication is not the same thing as an addiction. Although individuals who are addicted to a drug will be tolerant of and dependent on that drug, chemical dependence can be present without addiction. Those who are dependent but not addicted will experience withdrawal symptoms if they abruptly cease to take the drug, but they do not experience uncontrollable cravings and exhibit drug-seeking behavior.

When a patient becomes chemically dependent on a legally obtained prescription medication, the culpability will not always lie in the same place. Irresponsible behavior is possible on both sides, and it is often impossible for an addiction to form without a certain dereliction of responsibility from both patients and doctors.

Patient Abuses of Medications

For a chemical dependency or an addiction to form, it is often necessary for the drug to be taken in unsafe quantities and by methods that are not intended.

Prescription painkillers such as Vicodin, for example, may be chewed or injected rather than swallowed whole in order to bypass the usual process of slow digestion and release. This results in a high and a sharp spike of the drug in the bloodstream, which can quickly lead to addiction.

Patients who become tolerant of their medication sometimes seek to increase their dosage without consulting their physician. Some simply take more of the medication they have already been prescribed, while some will visit multiple doctors in order to secure multiple prescriptions of the same medication. These patients may not hope to gain any effects apart from the intended ones from this additional medication. They may not realize that stronger doses make them vulnerable to a dependency

When Doctor Oversight Fails

However, these transgressions on the part of patients taking medications often do not happen without failures on the part of the prescribing physicians. Occasionally, careless prescriptions may even lead to chemical dependency or addiction in situations where the patient is carefully following the instructions given to them.

Physicians (and to a certain degree, pharmacists) have various responsibilities when they provide patients with access to medications. When medications have the potential for serious side effects—such as addiction—patients should be aware of those risks before agreeing to the prescription.

Physicians should also use discretion when prescribing addictive medications to patients with a personal or family history of addiction. In those cases, the risk of developing a dependency is increased. As a result, smaller doses or alternative medications may be the best choice for those individuals.

The risk of dependency, addiction, and even fatality is also greater when patients are taking multiple medications that react poorly with each other. Physicians have the responsibility of documenting and consulting their patients’ medical histories so that they can avoid prescribing medications that may form a dangerous cocktail with others in a patient’s system. Requesting a patient’s medical records can also help physicians to detect individuals who are seeking prescriptions from multiple sources.

When patients are on medications with dependency or addiction risks present, physician oversight is important. When patients request dosage increases, or try to fill prescriptions well before the time when their current prescription should have run low, it is possible that patients have become tolerant of their current dosage or have independently bumped their dosage. Whether they suspect ignorance or deliberate abuse, physicians who recognize these any other warning signs have the responsibility to step in.

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