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Tuesday, March 14, 2023


This is really important information in terms of opioid prescribing because most people actually *don't* really love opioid effects and many find them aversive. But there's an assumption that the longer you take them, the more likely you are to get addicted (not talking about physical dependence, which will affect most with long term daily use). This cannot be true because people don't tend to go from really disliking something to loving it— in fact, there are links between opioid liking and genetics so it seems that genetically, either they make you feel good or they don't. While people can certainly change in terms of whether they like or dislike something, with opioids, this doesn't seem common: you seem to either like the feeling or not.

The problem is that in order to be addicted to opioids, you have to take them long term and so it looks like taking them long term is a risk factor, when, in fact, it reflects that people who like them more take them for longer, not that taking them longer turns large numbers of people into opioid likers. But we are determined to ignore this and make life hell for the people who have chronic pain and do benefit from opioids (not all, but not none either).

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