addicted or dependant?

There is such a fine line between addiction and dependence when a person takes pain pills for chronic pain.  How can you tell if a person is addicted or dependant on pain meds?  A friend takes them for chronic pain and I'm not sure if they are addicted or dependant.  Any advice would be appreciated.  thanks.

[GA Guy]

A diabetic is dependent on insulin. He's not addicted to a drug that he needs to live a normal life. Many people use opiates responsibly in order to live their lives. They use it to remove the pain and use their medications as directed. Using them to achieve a high and using more than necessary to achieve a high is addiction. Most people distinguish the two by saying that dependence is a physiological problem where addiction is a psychological problem.

[CATUF]

From http://headaches.about.com/od/advocacyissues/a/addict_depend.htm:

Fear of addiction... There is a belief dramatically fostered within the United States by the spread of misinformation that anyone who takes opioid medications is at substantial risk of addiction. In fact, the rate of addiction amongst those who are treated by a doctor with opioid medications is no greater than that of addiction in the general population. According to the National Council on Alcoholism and Drug Dependence there is a solid body of clinical evidence that patients with a history of substance abuse or alcoholism may have a genetic predisposition to poor control of their medications and to addiction. Physical dependence and tolerance are different matters: anyone who repeatedly takes opioids, whether for medication or to feed their addiction, more than likely will become physically dependent on the medication and encounter withdrawal if he/she stops taking it abruptly.

Ability to function divides the addict from the physically dependent pain patient. The Florida Board of Medicine explains addiction is characterized by "compulsive use, despite harm." Addicts become socially less functional as the drug takes over their lives. All thought revolves on where their next dose is coming from. Addicts are less able to handle their jobs, family obligations and social participation.

In stark contrast, patients taking opioids to relieve pain usually become more functional, able to rejoin the lives of their families and community and return to work. They're less depressed, less anxious and often view the change as "life-saving". Thus, the Florida Board of Medicine instructs physicians that "tolerance and physical dependence are normal consequences of sustained use of opioid analgesics and are not synonymous with addiction." This advice hasn't penetrated deeply even into the medical community. The general public and majority of the media still equate physical dependence and addiction; even those patients who have not been well counseled by their doctors may wrongly believe they are addicted.

[fibromama]

by Roger Gould, M.D.


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Roger Gould, M.D.  
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, Feb 19, 2008 04:19PM
To: summer123
If you are physically dependent, it only means that you will have some sort of somatic reaction when you stop using it.  If you are addicted, it means you not only anticipate a physcial reaction, you mentally don't want to stop the medication because you don't think you can emotionally survive without it.   Also, if addicted in a dangerous way, you have increased the dose to a level that interferes with your judgement and day to day functioning, and are getting a high from the medications.  that's the info, so you can decide..

[faith_hope_love]

I think I was both.  My body was dependant on them due to taking them for 6yrs. for back pain.  In the last couple of yrs. that I was on them, I became addicted because I built up tolerance, started taking more than I was supposed to and also I know for a fact that I was using them to numb myself because I was depressed..I lost my business and house because of my back.  It was a very sad time and the thought of starting over was freaking me out...still does.  

I just finally had to admit that I had a problem and deal with it.  I am so glad I did.  The only thing that is hard is that I still have the back pain...and neck pain. :-(  It drives me nuts some days but luckily the bad pain days are not that often.  In general, I do feel better off the lortabs.  Thank God for tylenol and Advil.  I don't think I could make it without some kind of pain reliever even if it is just over the counter now.

Anyhow, sorry to ramble on.  Have a good night all!

[broknbck]

well not sure. i was 'addicted' 'dependant' on pain killers for the last 2 years and was not getting high at all. just could not handle the withdrawl (withdrawal) along with the pain at the same time. also you do become emotionally 'attached' or maybe it is just the fear of knowing how bad the withdrawl (withdrawal) will be if you are to run out.

just because someone is taking their meds as directed. which is usually not to be taken every day. does not mean that they are not dependant or addicted. it's like whatever. if you quit taking the drug and suddenly feel like you are dying or not normal, than you are in trouble. addicted or dependant.

[faith_hope_love]

You make an excellent point.  I know I am gonna sound like a wimp but I was terrified of going through withdrawal and also knowing that I would go through withdrawals with a bad back..and neck.  The fear of these two things kept me from making a move for probably over a year or more.  Just looking at my initial posts months back, I was panicked.  I am surprised I didn't drive you all crazy with my need for constant reassurance.  I am so glad that part is over with.  

[broknbck]

hey, good for you. the panic and fear is so confining and makes you feel so in bondage or prison. i am glad for you that you have conquered the fear. it is the start.

are you off the drugs yet?

[faith_hope_love]

yes, I detoxed off of the lortabs with a 20 day sub taper back in May.  I am on tylenol now..lol.  Take care!