Addiction vs dependence

[taperme]

Hi...I'm really curious about all your opinions about the difference between addiction and dependence when someone stops taking opiate drugs. I had been on oxys and norco for several years. All prescribed. Never ran out earlly. Never took more than I was suppose to. Well, maybe a once or twice I tried taking an extra norco beyond what the doctor prescribed after I had built a tolerance. Realized that the extra one did nothing for my pain, and didn't make me feel high at all so I didn't do that again. Thank G-d. Finally a few months ago I decided that I wanted to be off of all of these pills that i was taking. I knew at that point I was dependent on them because of how I felt if I didn't take them. I dropped the 2 80mg oxy/per day that I was taking within a week. NO problem. Kept taking the norco for a while. Told my doctor that I was done with the oxy. He suggested waiting a while before tapering the Norco. Decided to do it anyway and tapered and stopped a 10 pill/day habit within 3 weeks. I'm on my 3rd or 4th day taking nothing and I feel great about it. I wish I felt a little better and had a bit more energy. I've had some bad anxiety, but that is really the worst of it. So, I'm wondering....what is the difference between addiction and dependence. AND does being successful at stopping mean I need to go to NA or something? I tend to think I was dependent, not addicted. But who knows...maybe I am wrong. I'm curious to your opinion. Thanks!

[taperme]

Thanks for your input. That's exactly what I am trying to do, is to be honest with myself about this. As I said, I only want to do this once whether it is because I am addicted or dependent...don't want to ever be in the same boat again. I will continue to think about it/ponder it, but I think only time will tell for sure. As of this moment, I have absolutely no desire to take a narcotic pain pill of any kind and would actually be sort of scared to do so. So far this week I haven't obsessed about pills. I've obsessed on how I'm feeling and my lack of energy, etc. But I really haven't thought about taking a pill. And here's one of the things I've realized...for me...I know that I could continue to take opiate pain pills legitimately. I've got physical issues. I don't want to anymore. And even when I have had the few quick thoughts of taking a pill I realize, I don't want to do it. And I am doing this truly for myself. Even though I finally confided the issue to my husband, it is me I need to be honest with. And it is me who wants to know that she is in control. Does that make any sense at all?

[WannaBeFree79]

For the 2-3 years I was prescribed pain killers I took them as prescribed, but I was Addicted.  I was taking them not only for the pain (which became very minimal) but because I enjoyed the euphoric feeling.  You can still be addicted taking it correctly, it depends WHY you are taking it.  In the 9 years I have been on vicodin I never got totally out of control either, I never took more then 2 at a time.  Even at a theraputic dose I am totally addicted.  Only you can decided if your addicted.  It really depends on why you are taking them.  If you get through your withdrawal with no mental side effects and cravings I would assume you were just phsyically dependent.  If you feel like you need this drug to survive, you think about it a lot, obsess about it, want to take it again, that to me would say addicted.

Someone who lets say takes 2 pain killers at 8pm everyday, not because of pain, but because it relieves the stress from the day and they can relax.  They are addicted but probably not physically dependent because of the low dose.  Probably well within the limits of their RX but taking it for all the wrong reasons.  

I don't know how else I could explain it, only each individual knows why they take the drugs, and can be the only one to determine if they are indeed an addict.  You have to be 100% honest with yourself to do this.

WannaBeFree

[taperme]

I think you are right! But you don't have to argue to the death! :)
I think...and only time will tell, that I walked a very fine line and it absolutely could have gone either way for me. I also think I am very lucky that I took this into my own hands instead of waiting for my doctor to do something about it. I could write a book about THAT. I mean how many times does a patient need to bring up getting off of narcotics before the doctor does something about it? Wasn't the fact that I took myself off the oxy's on my own a clue that I was serious?
Anyway, I will definitely keep posting. If I can help half the people who helped me I will be thrilled. AND I think it will be good for me as a reminder to continue to be thankful that "there but for the grace of G-d...go I" or somehting like that.
How are YOU doing?

[Greatgreebo]

i gotta say, if what you are saying it true then i would consider you DEPENDENT not addicted. This is just my opinion-but i would argue it to death with someone who wants to disagree (well, maybe not to the death :-). If sounds like you are doing everything right and i personally think you are smart to stop now-you never know when addiction will strike. i was a compliant pain mangement person forvever and then one day it started to get a little out of control and the next thing i knew  i was a full blow addict.
congrats on taking control now. you are doing an excellent job!!!
don't sweat it....you really sound like someone who is PHYSICALLY DEPENDENT (this is your body being dependent on the drug and you get sick when you first stop taking it) ...you don't sound like an addict (which is the mental part that drives you to abuse the drug and leads you to starting to use it again after the physical withdrawals are over).  Being dependent is a cake walk to get over
being an addict will take a life time of vigilence.
I'm very happy for you that you don't have to live a life with this monkey on your back. Like I said before--it's good to get out now, while you are still in control
Keep posting...there are people who can learn from you :-)
Stay strong
greebs

[pharma9]

I was thinking the same thing as you.If one is detoxing from normal doses of opiates and had not abused them and only taken them as prescribed......do they need aftercare..
Poochie's situation is like that and do these people really need aftercare even though they need help detoxing.
Their need for the drug was a little different and reasonably temporary.
In my pharmacy I have helped many such people detox from fairly short term opiate use and they did not need aftercare because the mindset was different.
Some detoxed from fentanyl patches and other opiates.

[taperme]

So, if I was not taking my prescriptions in an un-manageable way, and only taking them as directed, not running out early, not dr. shopping, snorting, taking more than directed, etc, and decided for myself that I didn't want to be on them any more, took control and responsibility for that, made and stuck with a plan, in your opinion would that suggest dependence vs. addiction?

And for others who've responded and read this...I am really trying to cover my bases here and be responsible in getting off of this stuff. I've read so much about aftercare and my thinking has been that that applies to addicts not dependancy. I am trying to cover my bases to make sure I do this right the FIRST/LAST time.

[Greatgreebo]

Dependency is the actual physical changes to your body which cause withdrawal. Addiction is the BEHAVIOR of taking the drugs to get high, not as prescribed, and when not needed for clinical reasons. It is the un-manageable behaviors associated with lack of control.

[taperme]

I thank all of you for your very thoughtful replies to this question. It has given me a lot to think about. I hope that nobody felt that my asking was in any way judgemental between anyone who is addicted vs dependent. I "almost" think it doesn't even matter to be honest. Maybe that is the withdrawals speaking and maybe I will have a little more clarity in a few days. But honestly whether I am addicted or dependent, the last few days have pretty much stunk. I don't think it matters whether I used prescription drugs in the way they were prescribed for me, or if I had gotten them off the street (which to be clear I never have). I think if you are addicted/dependent when you take the drug you have been on for a long time for whatever reason away, you are going to feel lousy for a while. One of the reasons that I asked was so that I could really take a good hard look at myself so that I never find myself in this place again.  You have all given me a lot of food for thought and I really appreciate you sharing your opinions and experiences. Thank you.

[GA Guy]

I'm not talking about a synonym in a thesaurus, I'm talking about in a medical context. Ask any drug or addiction counselor if the two are euphemisms and they will speak of them as entirely different medical conditions. The truth is that some addicts are not physically dependent. And, some people who are dependent are not addicts. I myself was an addict who had become physically dependent.

[Addict63]

...and then if you run "dependence" through the Thesaurus:
Can mean / reliance, addiction
Synonyms / reliance, trust, confidence, belief, hope and faith

Webster's Dictionary on the word dependency: 1) a need for something or somebody to be available in order to exist or survive. (which is your definition Ga Guy) 2) a physical or psychological need to use a drug or other substance regularly, despite the fact that it is likely to have a damaging effect.

Me? I call myself a complete alcohol and drug addict! No doubt about it. I have no problem with that term for myself. I lean on the Synonyms / reliance, trust, confidence, belief, hope and faith - in a power greater than myself.

[GA Guy]

Addiction and dependence are not euphemisms. They are tangibly different things in a medical context. Diabetes patients are dependent on insulin. They are not addicted. Addiction is a mental condition...dependence is the physical state. They are very different. I don't think non-addicts grasp this concept very well.

[cleanmom]

Physical dependence pretty much means that if you stop the drug your physical body may experience some uncomfortable withdrawal symptoms and it can also indicate that you are building up a tolerance to the drug and requiring a high dosage to get the same releif. Addiction implies that you will compulsively take the drug to alter the way you are feeling emotionally, it is indicative of a lack of self control with the drug. Although not always. Some people only take the same exact amounts of the drug every day but when they are taking it for reasons other than pain or what not, this is addiction. So do not assume that if you take you medicine in a way that you beleive is controlled that you are not an addict. Not so.  It has to do with the reasons behind taking it and the compulsions to do so.

[worried878]

A person knows deep down when they r mentally addicted..an Addict
Most pill poppers do not get the amount that u got from ur dr....personally my habit was never even half of urs...if a dr would have rx-ed this amount to me//the amount u described...i woulda never ran out early either/nor bought or traded for them..i topped out at 100 mgs a day but i WAS AN ADDICT//AM an addict..taking more than that served no purpose as i didnt get high anymore off of them
Taking narcotics as prescribed does not rule out Addiction....Not saying u were but just saying there are people out there getting prescribed 300-500 mgs of oxy or hydro etc added together to equal 300- 500 mgs a day of narcs....some go to shady drs who rx narcs for profit/some to legit drs who r just downright generous...the definition of addiction goes way deeper to me
1. I was never a heavy user in comparison to many here...to me I WAS tho..I got WORRIED!  LOL  
For me the realization of addiction came when I tried to take elss one day and could nt
2.  Sought out this forum...for me googling an addiction forum meant i may have a problem
3. I realized my narcotic use was no longer about pain and realized it was never about pain//narcotics do not even directly relieve pain and only interrupt the signals to the brain so u dont care anymore//unfortunately i didnt care about some important stuff either
4. I was rx-ed perhaps 20 mgs of hydro per day and I did resort to buying them...and trading with friends etc
5. I felt a loss of control...taking pills as soon as i got up just to move!  The pills became routine vs taking them for pain...and then i knew i was in trouble..trying to skip a day taking them was virtually impossible//unless i was out!

We are all different...sounds like u have ur bases covered
Most of the population are not addicts or narcotics wopuld have been taken off the market eons ago...it is a very small segmant of the population who become addicts///who search out narcs and abuse them...tous it seems anyone who takes a lortab or an oxy has a pill problem...but this is not true....
Glad u posted here even tho u r not an addict///there is alot of info here for anyone who needs it  

[WannaBeFree79]

My view on this may be skewed but this is how I think dependence and addiction are different.

Anyone addict or not who takes any drug for an extended period of time will grow a physical dependence.  Your body will withdrawal from the drug when you discontinue use.

Addiction to me is the emotional and mental attachment to the drug.  The mental cravings, even when the physical portion of withdrawal is over.  The love of the euphoric feeling.  For an addict you have both physical dependence and addiction.  

Thats just how I look at it.

WannaBeFree

[Addict63]

I forgot to add: Congratulations on your 4 days!! I wish you the best getting control of your life back.

[Addict63]

Good question...

I think the word "dependent" is a euphemism for the word "addiction". On my Vicodin ES patient instructions they use the phrase "Physical Dependence".  Pretty much, addiction and addict has social stigma and dependent sounds more palatable to consumers.

When you drop "addiction" into the MS Word Thesaurus they recommend the word "habit". They also offer: compulsion, DEPENDENCE, need, obsession, craving, infatuation. I don't think I'm "infatuated" with Vicodin, not in the least. It became the bane of my life. An expensive habit, physically, mentally and spiritually.

[avisg]

only you can answer that I dont find it interesting that you staid you took one extra but dint get any high ? the other problem is whether you are dependent or addicted you body feels it needs the drug to functions that is not a fun way  live what pain issues are u thaking them for .

[taperme]

Believe me, I don't have THAT much will power! I am very stubborn though! I definitely took them for legitimate reasons, but will acknowledge that I did like how I felt at the beginning before the tolerance built up. When I first took a vic, I felt some of what you describe...but not for long.


Would love to hear other opinions.

[freedom007]

Sounds to me like you either have the will power of a God...or are just dependent.  Most addicts are never able to taper, run out early constantly, relapse numerous times, detox numerous times, etc.  For addicts, the addiction is more about what it does for the brain than the body.  My wife would often ask, "what do they make you feel that makes them so special."  The only way I could respond is, "its what they make me not feel, that makes them so special.  No depression, no anxiety, confidence, energy, etc.  You may be dependent physically...almost impossible after taking them for many years...but sounds to me like you are not an addict or addicted.

I am sure that there are other opinions...but that is how I have always thought of it...