Major risk factors for addiction include those of the environment, more likely to affect initiation of use, and of the individual, where genetic factors are more likely to affect progression from use to dependence. An understanding of these risk factors will help the physician to counsel those at risk to avoid the initial use of or slow or stop substance use before it progresses to addiction. Further, the physician will be better equipped to make the often difficult decision of when to prescribe opioids for at-risk patients with chronic nonmalignant pain.
ABSTRACT