While she and Saper disagree about how widespread the problem of addiction to opiates is, most pain experts acknowledge that addiction can and does occur. Pain clinics, she says, prescribe opiates under very controlled conditions and monitor their usage carefully. Then if a problem like addiction does arise, doctors can respond immediately and appropriately. Morphine, is one of a class of pain-relieving substances that are characterized as opiates. Injuries to tissue or to the nerves in the body cause pain, which the brain detects.
Opiates work on receptors in the brain and in the nerves to block the pain.
While morphine is extracted from the poppy plant, other opiates, such as fentanyl, are manufactured by pharmaceutical companies either from scratch or from a compound that initially was produced by the flower. Doctors use opiates to treat the pain after surgery, or the pain associated with trauma, such as a severe burn. When morphine is overused, a patient may either vomit, itch or, like other opiates, stop breathing, which is why doctors prescribe this class of drug judiciously. The use of opiates over time can lead to tolerance, or the need for a higher dose over time, or physical dependence on the drug, but doctors say such conditions are not the same as addiction. By carefully weaning patients off the drug, they no longer will require it, according to Dr. Joshua Prager, director of the California Pain Medicine Center, in the medical center of the University of California at Los Angeles.