What is addiction and substance use disorders?

Substance use disorders refer to use of a drug, alcohol, or tobacco that is problematic and results in specific symptoms associated with use. These symptoms can be grouped in four domains:

• loss of control (e.g., unable to stop or cut down, etc.),
• social problems (e.g., work or relationship problems),
• risky use (e.g., use in dangerous settings, etc.), and
• drug effects (e.g., withdrawal, etc.).

Substance use disorders are medical disorders that respond best to medication and/or psychological/behavioral interventions.

Addiction is a broad term that includes substance use disorders, but is also used to describe other non-substance use behaviors where a loss of control and consequences of these behaviors are demonstrated (e.g., gambling, shopping, etc.).

What is acute and chronic pain?

• Acute pain does not last a long time. It is an expected result of illness, injury, and medical procedures like surgery. It goes away once you are healed and healthy. Acute pain is natural and helpful for healing.
• The experience of chronic pain is an entirely different matter. Acute pain can turn in to chronic pain, but we still do not entirely know why. Chronic pain is pain that is still there even after your body has healed. It serves no useful purpose, and it can really decrease quality of life. Pain is chronic when it is there for longer than six consecutive months. It is not uncommon for people to have chronic pain for years.

The overlap between addiction and pain

• More than 100 million Americans have chronic pain, and over 20 million meet diagnostic criteria for alcohol/drug addiction.
• People being treated for alcohol/drug addiction commonly report having chronic pain. A history of alcohol/drug addiction is often present among people who receive treatment for chronic pain.
• The widespread use of opioids to treat acute and chronic pain has contributed to millions of Americans using/abusing these medicines. Thousands of Americans die each year due to opioid overdose.
• Individuals with chronic pain may use/abuse other (non-opioid) substances as a means of coping with the pain. Alcohol, tobacco, and marijuana are commonly used/abused substances among people with chronic pain. Cocaine, amphetamines, sedatives, and hallucinogens are also used/abused to a lesser extent.