Addiction vs Chronic Pain Control

[busylady]

I've been reading the board for a while but this is my first time posting.  My question is how do you know when you have gone from taking your meds for real pain to just using them because your addicted to them.  I never take more than prescribed.  I don't call and ask for early refills.  Some days I take more than others because some days I don't take any at all.
If I am using them for the wrong reasons I really want to know.  I am also very afraid of dealing with the pain that brought me to the meds in the first place.  Any input you can give me would be greatly appreciated.

[minime]

Can you go without them for a few days?  Do you think about them all the time and panick at the thought of not having them?  I used to have such anxiety at the thought of running out.  

If you take them as prescribed and never need early refills, it sounds like you're OK.  As long as you really have legit pain.  If you feel in any way that it is getting out of control, make sure you tackle the problem now rather than later.

It's good that you are looking at this now.

[busylady]

Yes sometimes I do go days without them.  I do have legit pain have several chronic illnesses.  Even though I feel like I have everything under decent control my SO is questioning why I am still taking meds after all these years.

[minime]

So, tell him why you're taking the meds.  If you take them as prescribed, and you truly need them, you shouldn't worry about it.  He doesn't want you in pain does he?

[The Golden Slipper]

If you can go days without taking them it sounds like you are ok. However, my addiction began the same way.  I started wondering if I was taking too many, even though I only took them for pain and never got any early refills.

It is a good thing that you are looking at this, I know how hard it is to live with chronic pain and in my case it did turn into a fullblown addiction and reached a point where I would take 30 pills in 4 days and be calling for refills.

Would you believe I was able to get refills that early!! Once I realized how easy it was I kept doing it.  At some point it crossed the line into addiction and once there happens it is almost impossible to turn back.

You don't want to get to that point and I am not saying that it will ever happen but just keep track of how many you take and maybe look into other alternatives for dealing with your pain.

Best of luck to you
Golden Slipper

[pharmdee]

ADDICTION IS DEFINED BY THE FOLLOWING...COMPULSIVE NEED FOR AND USE OF A HABIT FORMING SUBSTANCE..(OPIOIDS,BENZODIAZAPINES,AMPHETAMINES,BARBITURATES,EXC..)CHARACTERIZED BY TOLERANCE..AND WITHDRAWL SYNDROME UPON NOT TAKING THE SUBSTANCE..COMPULSIVE USE OF A SUBSTANCE KNOWN BY THE USER TO BE HARMFUL.
DO YOU TAKE THE MEDICATION WHEN YOU ARE NOT IN PAIN?
DO YOU HAVE A CHRONIC TYPE PAIN?
HAVE YOU DEVELOPED A TOLERANCE THAT CAUSES YOU TO USE MORE OF THE SUBSTANCE TO CONTROL PAIN,THAN WHEN STARTED??

[busylady]

Sorry couldn't answer last night couldn't get on.  

I only take the meds when I am in pain which is most days.  I have been on the same dose for about 4 or 5 years no increase no change except to a breakthrough med with less tylenol.  One med is a timed release so even though I am suppose to take daily I don't.  Still use the same doc and pm doc.  Still use the same pharmacy.  Always use my insurance and never try to hide any of these things from anyone.  

[dancinginthedark]

Hi there,

At the outset of your initial post, I thought, no prob for her.
But the statement you made in 1st paragr., last sentence struck me as very "telling" even on my first read.

"Some days I take more than others because some days I don't take any at all".

To me, that single sentence spoke volumes but I may well have mis-read it or your intention.

What it said to me was you occasionally took more BECAUSE other days you didn't take any.  

As far as I know, we *should* only take pain meds when we need them for pain.  No pain?  Skip it & who cares how many are left or when your next refill is due?  If in pain, take it until you get on top of it.

Your statement read to me that pain doesn't always have anything to do with your usage & *that* is a classic sign of problem usage.

Oh, and I'm been quite a problem user myself & I do hope you won't take offense at what I've said here.  I just felt it behooved me to be honest.

I'm sure I'm wrong but that wouldn't be the first time!

All the best,

Dancing in the Dark

[dancinginthedark]

Which pain med have you been taking?  They're so different & I was just wonderimg as it might pertain to your initial qustion

Dancing...

[x04631218]

I have just started Revia after throwing in the towel by trying to do it myself, on will power alone....  


I believe it to be the silliest and stupidest thing to NOT do after an Ultra Rapid Opiate Detox.  Only now, since I started Revia TODAY, have I learned what it in fact is and the chemical effects and counter-effects on the brain after long-term opiate use.  I underwent Ultra Rapid Opiate Detox on 4/20/02, but began to struggle with relapse approximately 6-7 months later.  Prior to detox, I was at approximately 600 mg/day of Oxycontin, prescribed by my Doctor and paid for by Workers Compensation Insurance.  My spine had some minor injuries that were horrifically magnified because I began to self-administer Opium by smoking it to reduce my pain levels.  At the age of 25, my ignorance prevented me from seeing the slippery slope I had just embarked on, and the cost was not an obstacle. (Ironically, the cost was not a problem because I had been working so hard, which is why my spine was injured...The Irony of Life)

The chemical manipulation ones brain undergoes while under heavy opiate use is quite significant.  For Revia to be able to rapidly return the brain to its original "pre-addicted" stage is VERY important for the individual that has no physical craving for the drug at all to KNOW.  In this case, it is purely physiological.  

To throw the term "psychological" around without really thinking about the manipulation ones brain undergoes after being administered 400-600 mg/day of Oxycontin as a substitute for the self-administer of Opiate analgesia resulting from trauma to the spine, creates a sense of naivety about the treatment course and education required for those that are physically dependant due to injury, and not psychologically dependant due to drug abuse.  There is an important distinction to make, if only because the former may believe himself to have a strong will and believes, ignorantly, that he can prevent a relapse on his own.  

Until the chemistry in the brain is changed back to the way it was, the physically dependant will struggle with possible relapse as does the psychological addict, but they are not one and the same in structure, but surely both are just as important.  Unfortunately, the psychological addict will have a longer struggle.  

But it is the duty of the medical profession to make this distinction and educate their patients when appropriate, for this tiny bit of logical education about the effects naltrexone has on reducing the number of opiate receptors in the brain, can be the difference between life and death for many.

I Thank God for granting me the wisdom to see the ignorance in my ways, and allowing me to return to my true path in life.  Not just once, but whenever I have asked.  

PH

[drugzalots]

hello busylady, it sounds to me like you have no problem what so ever.  you may have a problem with your hubby tho, or he with your meds, i should say.  maybe he does not understand that some one could/can be in pain like you are all the time.  i couldn't beleave it till it happened to me.  imo, sounds like he is the one giving you your doubts.  maybe he needs to go to your pm dr and have the dr explain it all to him.  that way every one will understand better what is going on, and all the needless worring can stop.  jmo!!  take care!

[Bear_ChronicPain]

I'm 30 yrs old, and have been on opiates for about 5 years; I've been very ill and in a great deal of pain for about 9 years. I went to Dr's who just threw meds at me, docs who didn't believe me, and finally (when a Neurologist just didn'g give up, and they DID find my disease) my doctors now...who I thank God for them every day, ( and I live in city with URMC, a world renown Hospital . I've had this discussion SEVERAL times with my Dr's....

My disease causes chronic joint pain, and several other pains I could list that are a mile long...I wake in pain, and go to bed in pain...but for lack of time and space...I am on both long lasting opiates, as well as Immediate Release opiates. I know that without them, I would be immobile and would not be able to function.  

The bottom line, is there is a huge difference between "Addiction" and "Dependence"... I am dependent on my medications; physically, mentally, etc...but if I didn't need to take them, I wouldn't want to.  There have been times when I have returned a script to my Dr. a month later, because I didn't fill it because I had made the prior month's last long enough.

I have, in the past, actually forgotten to take my meds for a day or two, or just didn't need them.  I will be honest here, I ONLY realized it when I had terrible anxiety, tremors, and generally felt like I had the beginning symptoms of the flu....basically ~ withdrawl

SO. I am sure that people will argue this point, but unless your the type who calls early for meds, takes too many, "looses them" or my favorite I've heard "dropped them down the toilet/sink" ~ and your HONESTLY concerned about this, I do NOT believe that there is abuse here...if your taking them as needed, (some long acting meds are NOT meant for an "as needed basis") or lowering your long acting when not necessary...i.e: all the things you described yourself to do; I truly feel that you are DEPENDANT, however not ABUSIVE of your meds...you understand the pro's and con's and respect that.  

I also feel a large part of the population don't NEED to be on opiates ~ or at least not for a long amt of time.  There's really no disease that is treated by or with opiates.  There is certainly controversy over whether treating the symptoms &  the disease VS. treating the symptoms to the best of the Dr's ability, as well as treating the disease...even if that means putting the patient on strong pain killers.

I once went to a Dr., whose very first words to me, before talking to me, or seeing my file, were: "I rarely prescribe medications of any sort, and I never prescribe opiates."  Just the fact that this doctor had the nerve to say something like that, made me realize I was out of  there asap!!! When he saw my file, he stated that he couldn't help me anyhow, and I agreed...but my point with this story (long as it is!!!) is that I also feel very blessed to have a knowledgeable doctor who doesn't just throw medication at me, but takes the time to talk with me, and find what meds will work the best for me ~ opiate or not.  

This is why I respect my doctor now so much, and would never, ever think about abusing my medications, putting myself, and him, in the position of asking for meds early. He is, in fact, putting a great deal of trust and faith in me simply by giving me the medications.  I respect that he could loose his license for over-prescribing, prescribing where not needed, etc....(ok, before you jump down my throat...maybe loosing his license is a bit much for this analogy, but you catch my drift!!! :))

My point is that I have TRUE pain, and he knows that...he also knows that he CAN do something about it, and opposed to the Dr. who walked in and immediately announced he prescribes NOTHING (this was a PCP, who I was seeing for the first time, with a sore throat which turned out to be thrush, and he HAD to prescribe, and voiced that he was very unhappy->as I said, he then told me that I had to find another PCP, although I had absolutely NO intention on going back!) my doctor DOES something bc he can...and he recognizes true pain.

BACK TO YOU!!!!!!!!!!!

I get the feeling that your doctor sees this in you as well..hang in there. Chronic pain is TERRIBLE...and sometimes, the psychological part can be worse. If someone cannot SEE your pain, some assume you don't HAVE the pain....

Be strong. I have a feeling you already know the answer to this question you posted......

God Bless, I'll keep you in my prayers....

[avisg]

Bear this post is from 2003 why dont you start a new thread