What is dependence and addiction to medicines?

Most medicines will not cause dependence or addiction. There is a difference between dependence and addiction.

Dependence

Dependence is when you have a physical need for something. Withdrawal symptoms often appear if you stop taking the medicine. Your body can become physically dependent on some medicines if you take them for a long time.

You may be dependent on a medicine used to manage a health condition such as:

• diabetes
• a heart condition
• epilepsy
• depression

Don’t suddenly stop taking medicines without talking with your doctor about it.

Addiction

Addiction is the need to do, take or use something, to the point where it could be harmful to you. Addiction has negative effects on your life.

When you are addicted, you can’t control your use of the medicine. You find it difficult to stop.

You can have a physical or psychological addiction, or both.

Addiction or dependence can happen to anyone.

What are the symptoms of being addicted to medicines?

Some symptoms of being addicted to a medicine are:

• needing to use it regularly, or in larger amounts to cope with everyday life
• using more of the medicine than was prescribed
• cravings, or a strong desire to use the medicine
• feeling anxious about not being able to get your medicine
• spending too much time getting, using or recovering from the medicine
• finding it hard to cut down or stop using the medicine
• continuing to use the medicine, even when you know you have a problem
• having withdrawal symptoms — unpleasant feelings of illness if you stop taking it regularly
• feeling judged or ashamed when your pharmacist or doctor wants to discuss how much medicine you are taking

What causes addiction to medicines?

There are many ways you can get addicted to medicines.

Like alcohol or nicotine, some medicines make you feel good and create a powerful urge to use them again.

If you are dependent on a medicine, not having it can cause withdrawal symptoms. Withdrawal can be unpleasant, so it can be easier to carry on taking it. This can lead to a cycle of addiction because you need to take more and more medicine to feel good.

Some addictions may be genetic and run in your family.

An addiction can be a way of blocking out difficult issues such as

• unemployment
• poverty
• stress
• relationship breakdown

What types of medicines can I become dependent on?

Here are examples of some medicines that you may be dependent on. These are not addictions.

• If you have diabetes, you might rely on insulin to manage your blood sugar. This doesn’t mean you are addicted to insulin.
• If you have epilepsy you will need to take medicines to prevent seizures (fits).
• If you have some mental health conditions you may use antidepressant or antipsychotic medicines.
• If you have high blood pressure, you may use antihypertensives.
• If you have cancer pain or chronic pain you may be dependent on medicines to control the pain.

Examples of medicines that you can dependent on are paroxetine (antidepressant) or clonidine (used to treat high blood pressure). These medicines don’t:

• cause addiction
• lead to cravings
• lead to a desire to start taking them again once you have stopped

Do not stop taking these medicines suddenly. If you are on a high dose you will need to slowly reduce the dose.

If you take medicines for pain, anxiety or sleep for more than a few days you could become dependent. If you keep taking these medicines when they are no longer helping your condition, or not as prescribed, this can lead to addiction.

What types of medicines can I become addicted to?

Some medicines should only be used for a short time (days or weeks) because of the chance of becoming addicted. These medicines can have mind altering properties. A prescription from your doctor is needed and there are limits on the amount of medicine that you can get.

Opioid pain relief medicines

Some strong pain relief medicines are known as opioids. These medicines include:

• codeine
• tramadol
• morphine
• oxycodone
• fentanyl
• tapentadol

All opioids can be addictive and should be used with caution — especially if you have had problems with alcohol or substance use before. Heroin is also an opioid.

Nerve pain medicines

Some pain relief medicines were developed for epilepsy but can also help with nerve pain or anxiety. For example, pregabalin or gabapentin. 

Sleeping pills

Benzodiazepines are prescription only medicines used to help with sleeping problems or anxiety. They can be addictive. Examples include: 

• diazepam
• temazepam
• nitrazepam

It’s best not to use these every day, or for more than a few weeks. Read more about the safe use of sleeping pills.

Stimulant medicines

Stimulant medicines, such as methylphenidate and dexamphetamine, are used to treat:

• attention deficit hyperactivity disorder (ADHD)
• narcolepsy (repeatedly falling asleep during waking hours)

These medicines can be addictive if used incorrectly.

When should I see my doctor?

If you have a problem with medicine, use you should see your doctor.

You might need medical support to help you quit if you are addicted to a medicine. Your doctor can help you to safely reduce your medicine use and manage any withdrawal symptoms.

How is addiction to medicines treated?

If you are addicted to medicines you may be treated with:

• lifestyle changes
• weaning off by slowly decreasing the dose
• counselling — help for the underlying issue that led to addiction
• rehabilitation support
• detoxification in a hospital or clinic

How can I avoid addiction to medicines?

If you have been prescribed a medicine for pain, stress, sleeping problems or anxiety, you can ask your doctor about your risk of getting addicted.

Use your medicines exactly as prescribed.

Questions you can ask include:

• What are the side effects of this medicine?
• Is this medicine addictive?
• How long should I take the medicine for?
• Do I have to take every pill?
• What are the signs of dependence or addiction?
• What are my alternatives to taking this medicine?
• What else can I do to help my condition?
• What’s the plan for dealing with my problem long-term?

It’s important to use your medicines as prescribed and never use someone else’s prescription medicines or give your medicines to them.

Look out for the symptoms of being addicted to medicines and talk with your doctor or pharmacist as soon as you can.

What are the complications of addiction to medicines

If you are addicted to medicines there are negative effects because obtaining and using the medicine becomes more important than other activities or relationships in your life.

You might

• fail to meet your responsibilities at work, home or school
• stop attending or enjoying social or leisure activities
• have an accident or harm yourself due to drowsiness or poor judgement
• become involved in crime to obtain more medicine
• take an overdose of medicine leading to illness or even death

Resources and Support

If you have a medicine use problem, ask your doctor or pharmacist for help.

You could also try these helplines:

• 1300 MEDICINE is a free service where you can talk to a pharmacist for advice about your medicines on 1300 633 424.
• Alcohol Drug Information Service (ADIS) 1800 250 015.
• Alcohol and Drug Foundation 1300 85 85 84.
• Lifeline provides crisis support 24 hours a day. You can call 13 11 14 or chat with a trained Crisis Supporter online.
• Family Drug Support Australia is a support service for families affected by drug issues. They can be called on 1300 368 186.

Online information and support is also available from:

• Counselling Online (for chat or SMS support)
• Alcohol and Drug Foundation Path2help tool

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.