In fact, they indeed are both, but the inspirations for the behaviors are quite diverse. The particular 'pleasure' that pain patients get from narcotic use is pain relief. A witty young woman was asked by a nurse which drug she was addicted to. Addicts use drugs to escape from reality. Pain patients use them to return to reality.
Addicts use drugs to escape from reality.
Pain patients use them to return to reality. Addicts want to avoid lives normal stresses, while pain patients want to have the freedom to battle with them. Aside from the physical pain, pain patients basically enjoy their psychological lives. Addicts use drugs to avoid their psychological lives. Very few pain patients ever become addicted in the same sense as the common notion of the street or dysfunctional addict.