There absolutely is a proven genetic component to whether opioids will give you the high and mask the pain. There is also a (different) genetic component to whether a person is more likely to become addicted to a high like this. Finally, there are environmental components that guide a person away from becoming addicted. There's a reason that the Vietnam vets who shot up on morphine during the war did not become permanently addicted. Some did, but the ones who didn't had strong safety nets and support and "reasons to live" when they came back home.

I can’t get past the aweful nausea and constipation. So no oxy anything for me. Ever.

I think for those who become addicted, it’s a mix of genetic predisposition AND mental health. For example, for someone who is depressed, has an anxiety disorder or some other mental health issue, opioids could bring relief from that emotional pain. This is my theory based on personal experience with a very close family member. Her parents were addicts (genetic predisposition?), she was depressed and had serious anxiety and an unstable life, along came a script for opioids to help with some chronic pain she was having...shortly thereafter came the heroin.

I had a friend who had surgery and a two week scrip for pain meds who had withdrawal symptoms that were severe enough to land her in the ER after those two weeks. She wasn't pleasure-seeking about it all all, either--she'd had a parent die from an overdose, and didn't even want to take the meds in the first place. She ended up needing medication to get off of the medication--and, again, at no point was this fun for her.

On the other hand, I've taken opiates for fun, sometimes for weeks at a time, and had no physical effects to speak of when I stopped. (And I always did stop--in the last decade I've had pain meds twice. Always thrilled to get them, always fine when they run out.)

Based on my experience and hers, I'd say the conversations about addiction need to focus less on blame and more on physiology.

I think it may be genetic or something. I've been prescribed tons of opiods for surgeries and frequent kidney stones. I used to be given bottles of Dilaudid and other Opiods. All they ever did was upset my stomach and make me feel sick. I never got a good feeling from them. I don't even use them for my kidney stones anymore, I just deal with the pain because they make me feel so sick. I've taken way bigger doses of Dilaudid than prescribed, and it never gave me a good feeling at all.

A lot of addicts first started out with chronic pain - back issues, work related injuries, surgery recovery, etc. Once you're in pain, you quickly feel self pity, depressed, unmotivated too.
Those opiods sure do work wonders and make you feel great, but if you stop popping them then you got back into the painful slump. So you keep taking them.

Remember, outside of the DC bubble, there aren't any/few resources to help people curb themselves. Do you think west Virginia MeMaw is going to be motivated to consistently go to physical therapy each week, for example, to help her chronic back problem or woukd it be easier to just pop a pill? Or tell her doc that her back feels better so no need to refill her prescriotion?

I think there has to be some sort of genetic predisposition. I also have been prescribed several different types of opioids over the years (and way too much each time, IMO) and I was meh about it. I guess I felt something but I didn't like it. I've returned prescriptions to the doctor only half used. I think it clicks really well with some people but not with others.

I was on the max dose of pain meds for 6 weeks for an acute back problem, had to see Drs that specialized in pain management and pee in cups to get more pain meds (they make you do this to prove you arent selling the meds) and I never felt any euphoria from them, However, when I tried to stop them I found I got irritated and felt weird - so I could tell my body had somehow become addicted. So you basically have to step down in dosage slowly.

They take 'em, like 'em, and keep with 'em. These are not our brightest bulbs.

They made me feel so sick. I could not take pain killers when I was in pain. There was no pleasure or comfort in it. I agree that it is a question of your own body chemistry.

There but for the grace of god go I.

I don't think anyone gets hooked on oral prescription painkillers after a single week. (The story is different for someone using straight heroin who can become addicted almost instantly.) However, the pills definitely make some people feel good and energized. Certain people are also genetically predisposed to becoming quickly addicted. Once the pills don't work so well and become increasingly hard to obtain, people find that street drugs (heroin, fentanyl) are cheaper and easy to get.

I was recently prescribed opioids after a surgery and was extremely disappointed. They were not great with the pain and I did not feel amazing. I thought this was going to be the silver lining of my surgery! There was nothing worth going out of my way to get more.

^I’m the opposite. The very smallest dose of an opioid medication like hydrocodone makes me feel amazing. I’ve had a problem with these meds in the past. Agree on the genetic component.

I think there's a strong genetic component to addiction. I was prescribed opioids post major dental work not long ago, and felt nothing. The meds didn't even help much with pain - 800mg ibuprofen worked way better for that. I had never taken anything heaver than OTC meds, and the opioids literally did nothing for me from the get go - no happy, light, pain-free feelings. They were pointless for me to take.

I've taken hydroxydihydrocodeinone and percocet a few times for major surgeries. Admittedly, even for pleasure in my young twenties with friends (I was a given a gross amount of hydroxydihydrocodeinone each time, enough for leftovers).

But I hear about people like Kanye West who become addicted after one surgery. Even those who have mandatory surgery with legitimate pain become hooked after a week. I just don't understand how something so volatile and destructive is like a Tylenol for others. Is it just a matter of time until the opioid becomes addictive? Or are some people immune to the addiction aspect? Could we screen for that before scheduled surgeries?