Is addiction inevitable?

[Joe]

Hi,

I take roxicodone (3-8 5mg pills/day) for chronic pain following a car accident several yrs ago.  The meds are given by a pain specialist who is currently trying other methods to treat my pain(botox injections, denervation etc). I take the smallest possible dose to handle the pain.  My question is; is addliction inevitable?  will  I be escalating to 25-50 pills/day?  Also if I have to use the roxicodone for the rest of my life, are there any ill effects to any organs?

P.S. for those of you that don't know, roxicodone is oxycodone WITHOUT the tylenol.

[tom to joe]

I'm interested to read Dr Steve's response, but in the mean time, I can tell you what I know.

When you talk about addiction to narcotics, you have to address both the physical and mental aspects of addiction. Additionally, you have to address tolerance.

Narcotics, or to be more precise, opiate or opiate-like drugs such as roxicodone (what a catchy name), morphine, vicodin (hydrocodone), codeine, darvon, all mimic endorphins, naturally produced substances that play a role in the body's reaction to pain and stress. I find it amazing that mother earth gives us a substance that just happens to look like such an important substance. Imagine the suffering that would go on if there was no opium poppy. I just attended my 10-year old nephew's funeral. He died of cancer, but was spared years of agony by a wonderful substance called morphine, derived from the opium poppy plant. What a blessing! I reject the notion that these drugs are evil. On the contrary … but to get back to your point:

According to what I know, it is a given that the human body naturally adjusts to long-term continual opiate use, resulting in tolerance (the need for more to achieve the same effect). By the same token, this natural reaction also means that sudden discontinuance of opiates results in the withdrawal symptoms we all know and love.

Joe, as far as I know, that much is unavoidable. But the rate at which you develop tolerance can be intelligently managed by the right doctor (and patient). You almost certainly will have to gradually increase the dosage of roxicodone as time goes on, but by no means do you have to end up "needing 20-50 pills a day." That kind of need develops in response to the other aspect of addiction, psychological dependence.

Whether or not you develop psychological dependence on roxicodone is very much up to you. Are you going to use it solely to relieve your physical pain, or are you going depend on it to relieve psychic pain, or relieve boredom, or just to have fun?

It's finally all up to you. Anyway, that's as much as I know. Perhaps someone like Kaylen can add something. Good luck to you.

[to doc dan from joe]

Tom,

Thank you for your reply.  After reading many on the posts on the forum I got kind of scared of my meds and started "under medicating" myself thinking that I was playing with fire.  I don't want to be in pain but I don't want to ruin my life either, its comforting to know I can do one without the other.

[kelly]

i would like to no more about benz's for tapering isnt this subbing for drug prob for another?? Just my opinion

[tom to joe]

Joe, I have read in the Journal of the AMA that studies have conclusively shown that under-medicated pain patients take longer to heal and have more complications than patients who are kept out of pain. The theory is that the body and mind are worn down by having to fight pain and this dramatically reduces their ability to heal and recover. Your body will tell you how much it needs. just use your head. But there is no need for you to suffer. Take care.

[tom to kelly]

if you do it right, the benzo detox will not leave you with a different addiction. It's meant to be used for only about a week or less while you're going through the worst of the detox. Benzos help immensely with the body pain and emotional strees of the first week of detox. That and lots of jacuzzi's or hot baths, and the detox won't be as bad as you might think. the idea is to start with what amounts to a "knockout" (sleep inducing) dose of, usually, valium, then tapering it down over about a week. During that time, you use absolutely no opiates. It's kind of a moderate version of this new detox where they literally put you under anesthetic and feed you naloxone, an anti-narc drug -- but that one costs a lot and cannot be done at home. To really do the benzo detox right, it helps to be in a detox unit, but if you have a partner who can totally control the med dispensing, and a home that you can virtually run like a hospital room, you can do it by yourself. Good luck!

[Rand]

I posted this in the Xanax thread but meant to post it here.
----
Here are some web sites I dug up which have lots of information on benzos and withdrawal.
Sincerely hope this helps some people come to a better understanding of these drugs.  Actually everyone on benzos should bookmark this site and notice the support group for those needing withdrawal advice:
http://www.geocities.com/benzowebsites/index.html

[lexi]

Have any of you guys ever tried the "no Rx" online pharmacies?  If so, any luck?

[tom to Lexi]

I've been tempted to, but, I mean, how could it be legal and operate on the net out in the open, use the U.S. Mail and not have somebody on one end or the other get busted? Number one, I am NEVER going to do anything to get myself arrested again. Number two, what's stopping them from ripping you off? What could you do if you send a money order and never get anything back? Maybe someone else online tonight can help with info.

[Jo NYC]

There was an extensive article over the summer in the NY papers regarding those online pharmacies.  First of all, they'll get you all the Viagra, Valium, and diet pills (phen-phen, etc.) you want quite easily, but as far as the narcotics, the undercover reporter found the same story on several websites.  First, they make you buy a book and join a "service".  This can be anywhere from $100-$300 to start up.  We all know that when you're out of your legitimately prescribed batch and it's too early to renew, money is NEVER an issue, just getting those pills!  Anyway, these books and services allegedly give you a list of contacts and pharmacies in Mexico.  But, they were never successful in procuring any opiate pills, just spent alot of money.  This is a big scam that prays on the desperate addict.

Maybe somewhere people are successfully getting them online, or by mail from foreign pharmacies, but it's not common.

Ironically, this article was in the papers at a time when I was that desperate addict, juggling doctors, pharmacies and insurances to get by (my addiction was Vicodin).  I had been researching those websites as backup to my regular prescriptions which were not enough to cover my habit. It saved me from wasting my money and worrying about legal reprecussions.

My advice would be not to explore that option.  Although I'm not here to judge or preach (I've been where you are), I finally said enough and I am my the fourth week of being totally clean.  It was hell on earth going through the withdrawl and the detox, but I am very happy to be off that poison that was ruining my life.

Good luck to you in your endeavors.

[Lexi to Tom and Jo]

Thanks for the info... Like they say, anything that sounds too good to be true probably is. When you're desperate you grasp at things that aren't there. I've even thought of growing my own opium poppy plant!

[Frankinscense]

Addiction of the opiate variety. The Endorphin system and other neurohormones are effected by opiates. When opiates are introduced to the body endorphin production is compromised. The body looks at opiates as endorphins because they are so similar in chemical structure it (the body)does not know the difference. The body stops producing endorphins as a result.Or dramatically slows down their production. When opiates are stopped (COLD TURKEY) withdrawals start because there are no stores of endorphins in the body. That is why you have all these unpleasant feelings when opiates are stopped. A slow withdrawal or tapering allows the boy to start producing endorphins in  natural way.  This is a very simple explanation because there are many other neurotransmitters involved. SOME PEOPLE THROUGH YEARS OF HIGH DOSES OF OPIATES MAY BECOME ENDORPHIN CHALLENGED. Requiring opiate agonist therapy for the rest of their lives. I am certian that some of you will have to do this especially if you have been abusing opiates in heavy doses for twenty some odd years. Methadone is the only solution to this type of addiction.  Good luck and best wishes! Doc Dan (cdci)