From statements made about opioid use in Exit Wounds: A Survival Guide to Pain Management for Returning Veterans and Their Families, by Derek McGinnis, an Iraq War veteran. Exit Wounds is one of several publications that were funded and distributed by Purdue Pharma, which has been sued by forty-eight states. The Massachusetts suit, which accuses Purdue of creating and profiting from the opioid epidemic, cites Exit Wounds for the book’s misleading claims.

The pain-relieving properties of opioids are unsurpassed; they are today considered the “gold standard” of pain medications, and so are often the main medications used in the treatment of chronic pain. Yet, despite their great benefits, opioids are often underused. For a number of reasons, health care professionals may be afraid to prescribe them, and patients may be afraid to take them. At the core of this wariness is the fear of addiction, so I want to tackle this issue head-on.

If your body adjusts to a drug or medication, it may become less effective over time. This is called tolerance. This is simply a physiological process that doesn’t occur for all people or with all medications. Many people with persistent pain, for example, don’t develop tolerance and stay on the same dose of opioids for a long time. Physical dependence means that a person will develop symptoms and signs of withdrawal if a drug or medication is suddenly stopped or the dose is lowered too quickly. Withdrawal can be a problem with many medications used on a long-term basis, such as antidepressants, anticonvulsants, and medicines prescribed to control high blood pressure. Physical dependence is normal. This does not mean you are addicted.