NCLEX Practice Quiz: Managing Pain in Sickle-Cell Anemia Patients NCLEX Review: Differentiating Physical Dependence, Tolerance, and Addiction in Patients with Sickle-Cell Anemia What is the most reliable symptom or behavior associated with addiction that a nurse should recognize when a patient with sickle-cell anemia expresses concern about developing an addiction to pain medication?* 1. Withdrawal symptoms when the drug is abruptly stopped 2. Withdrawal symptoms when the drug dose is reduced 3. Habitual and compulsive use of a drug 4. A state of adaptation Δ