A patient is ready for discharge home from a lengthy hospital stay after a motor vehicle accident. The patient suffered multiple fractures and required large doses of morphine for several weeks. The nurse preparing the patient for discharge notes that the patient requests the maximum dose of the oral opioid analgesic at the exact intervals it is prescribed. The nurse is correct to suspect what has occurred?

A. Drug tolerance: Tolerance occurs when the body adapts to a drug, requiring higher or maximum doses to achieve the same therapeutic effect. The patient’s consistent request for the maximum prescribed dose at regular intervals reflects the body’s reduced response after prolonged opioid use. B. Compulsive drug seeking: Compulsive drug-seeking behavior is characteristic of addiction, in which a patient prioritizes drug use despite harm. In this case, the patient is using opioids as prescribed without out-of-control behavior. C. Cross-tolerance: Cross-tolerance occurs when tolerance to one drug confers tolerance to another drug in the same or related class. While opioids can cause cross-tolerance, the scenario only highlights reduced effectiveness of the prescribed opioid, not cross-reaction. D. Physical dependence: While possible after prolonged opioid use, the key finding here is the need for higher dosing at exact intervals, which points more specifically to tolerance rather than dependence.