So just in terms of the basic mechanism of the medication, if a patient is on it for weeks or months, she will develop a tolerance, requiring a higher dose for the same analgesic effect. She will also develop a dependence—as I did—meaning that when she tries to stop, withdrawal symptoms will provide a major obstacle. Since the body’s respiratory and other systems do not become tolerant to the dose increase as fast as they do to the pain-relieving or euphoric effects, increasing the dose increases the risk of overdose. And finally, the euphoric effect on the brain’s reward system makes the drug
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