I looked at the recreational drug articles after my daughter asked me a question about recreational drug use, and the stuff she had read in Wikipedia. I admonished her never to believe anything she read in Wikipedia, then had a look. How about this:



Everything I have read about heroin (and experiences of friends in the 1980s who became addicted) suggests it is extremely psychologically addictive. You can quit the stuff but the cravings continue for months or years. It is extremely irresponsible of Wikipedia to allow material like this. The National Institute of Drug Abuse tends to agree



Even other Wikipedia articles agree.



The problem is that children of my daughter's age really believe that Wikipedia is a reliable reference work.

Yikes. Some of the scariest stuff on Wikipedia is in the medical articles.

I spent a little time editing Tramadol because it seemed almost as interested in discussing whether the generic was good as the brand "for recreational purposes", another which overhyped an FDA letter about ensuring it was prescribed correctly, opining about the cost of brand name drugs, and a couple of copyvios as it did about discussing the drug 'properly'.

The statement should have been qualified. It isn't whether long term use of opioids is often psychologically addictive, but under what circumstances. The use of opiates was opened up several studies showing that they could be used in chronic cancer pain with little risk of psychological dependence (if the cancer was cured, they could be withdrawn with no craving, though physical withdrawal occured). Since then, a number of small studies have suggested that the same is true for their use in any type of severe chronic pain, from any cause. People tend to get into trouble when using opiates to treat psychological pain to begin with (pure recreational use) or when using them for physical pain which is of uncertain causal nature, like low back pain and fibromyalgia (here, some large component of the pain may be psychological anyway). These people have a far higher risk of psychological dependence.

Here's an example (a small study, but at least it's a study).

Pain Med. 2005 Mar-Apr;6(2):113-21.

A randomized, double-blind, placebo-controlled, cross-over pilot study to assess
the effects of long-term opioid drug consumption and subsequent abstinence in
chronic noncancer pain patients receiving controlled-release morphine.

Cowan DT, Wilson-Barnett J, Griffiths P, Vaughan DJ, Gondhia A, Allan LG.

Academic Department of Anesthesia, Northwick Park Hospital, Harrow, Middlesex,
UK. david.t.cowan@kcl.ac.uk

OBJECTIVES: The long-term use of strong opioid analgesics among chronic noncancer
pain (CNCP) patients remains controversial because of concerns over problematic
drug use. However, previous surveys suggest that this is not necessarily the
case. Therefore, we designed a controlled study to generate evidence in support
of these findings. PATIENTS/SETTING: Ten CNCP patients attending the pain clinic
in a district general hospital had been taking an average daily dose of 40 mg
controlled-release morphine sulphate (mean 40, range 10-90, SD 21 mg), for an
average of 2 years (mean 2.175, range 2-2.25, SD 0.2 years). DESIGN: Randomized,
double-blind, placebo controlled cross-over study. The study was based on the
premise that abrupt cessation of opioid drugs is most likely to highlight
problematic use and the consequent inability to stop using opioids. Morphine was
substituted with placebo for 60-hour periods to compare the effects of abstinence
with those of continued use. Assessment of morphine cessation and abstinence
effects was through direct observation, physiological measurements, questionnaire
responses, and Brief Pain Inventory scores. RESULTS: Following cessation and
abstinence, there were no indications of psychological dependence or drug
craving, but there was evidence of the detrimental effects of pain intensity on
activity, mood, relationships, sleep, and enjoyment of life. Three patients (30%)
reported opioid drug withdrawal symptoms. Pharmacokinetic data demonstrated
compliance with abstinence by all patients. CONCLUSION: The results suggest the
existence of a group of CNCP patients whose long-term opioid consumption can be
beneficial and remain moderate without them suffering from the consequences of
problematic opioid drug use. PMID: 15773875

The other WP articles you quote don't really make much of a distinction in circumstances of use. I think from what I can find in the literature that the general medical take is that when opiates are used to combat real physical pain, even for long periods, risk of psych dependence is present, but greatly lessened.