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Drug addiction is a disease in which there are three elements
Loss of control (also called compulsive use) of a drug – the person uses more than intended, is unsuccessful in attempts to cut down, etc.
Continuation despite significant adverse consequences – disease or injury, job loss, relationship difficulties, arrest, etc.
Preoccupation or obsession – over obtaining, using, and recovering from the effects of the drug.
Wow that was me to the T....Knowing this about myself means that i have to find another way to deal with the pain i've dealt with every day for years. Though it hurts to stand and it hurts to sit and i can barley hold a peice of paper without dropping it after 30 seconds....I must find another way because i am an addict.
YOUR NOT AN ADDICT
Jul 15, 2008 10:41PM
- 7 comments
There has been some conversation on dependence and addiction in pain Pt's and I want to make sure that it is very clear that its medically proven that one who takes pain meds for pain is not an addict but dependent on their meds for pain control. It angers me that there are actually people in pain that will not take pain meds because of the stigma attached that says they are drug addicts if they take prescribed medications. I am going to post some facts about this and stress that just because you take medications for pain that DOES NOT make you a drug addict!
Informational facts to follow...
Informational facts to follow...
JAMA....
Addiction is a compulsive disorder in which an individual becomes preoccupied with obtaining and using a substance, the continued use of which results in a decreased quality of life. Studies indicate that the de novo development of addiction when opioids are used for the relief of pain is very low.
The clinical use of opioids shows a difference between their clinical pharmacology and their laboratory pharmacology. What happens when opioids are given to someone in pain is different from what happens when they are given to someone not in pain.The difference in opioid pharmacology between individuals with and without pain also applies to addiction. The drug-seeking behaviour synonymous with drug addiction does not occur in patients after pain relief with opioids.
http://www.jr2.ox.ac.uk/Bandolier/booth/painpag/wisdom/lancop.html
Understanding physical dependence versus addiction.
Physical dependence is a property of various classes of drugs, including opioids and corticosteroids. Once the body has become habituated to such drugs, abrupt cessation results in a recognizable withdrawal syndrome. Full-blown withdrawal from steroids and alcohol is potentially fatal; withdrawal from opioids is uncomfortable but rarely dangerous. Some drugs of abuse are associated with a withdrawal syndrome; others (such as cocaine and marijuana) are not. Withdrawal symptoms can be avoided by tapering the drug, as every practitioner who prescribes corticosteroids knows. Physical dependence is a different phenomenon from addiction. Confusion arises because opioids can produce both physical dependence and addiction. Pain patients treated chronically with opioids often become physically dependent, but only occasionally develop de novo addiction. A prior history of drug or alcohol addiction or abuse increases the risk of addiction.
Drug addiction is a disease in which there are three elements
Loss of control (also called compulsive use) of a drug – the person uses more than intended, is unsuccessful in attempts to cut down, etc.
Continuation despite significant adverse consequences – disease or injury, job loss, relationship difficulties, arrest, etc.
Preoccupation or obsession – over obtaining, using, and recovering from the effects of the drug.
Signs of possible drug addiction in the medical setting may include:
Repeatedly using up the drug before the next refill (but see the section on pseudoaddiction below!)
Frequent requests for early refills, recurrent stories that the medication was lost, stolen, fell down the toilet, was eaten by the dog, etc.
Abuse of illicit drugs
Selling prescription drugs
Injecting topical or oral medications
Notice that the word addiction appears nowhere. Instead, the word has been replaced by the term dependency, so that opioid addiction is called opioid dependency, which is not at all the same thing as physical dependency on opioids. This is why when discussing issues of opioid addiction versus physical dependency, it’s crucial to make the distinction.
Pseudoaddiction versus addiction
In the clinical setting, undertreated patients may look like addicts, because in their efforts to obtain more pain relief they may use more than prescribed, go to more than one prescriber to gain opioids (“doctor shopping”), or make up stories why they need early refills. Behavior that results from undertreated pain rather than from addiction is called pseudoaddiction (Weissman DE 1989). Some prescribers do not realize, for example, that giving 100 Percocet (containing 5 mg oxycodone) for a month may be seriously undertreating a patient with significant 24/7 pain. If in doubt, the prescriber can give the patient a week’s supply of their pain medication at a dose that they say has worked for them, then see the patient back in a few days, along with the prescription bottle, and see what happens. In a legitimate patient who has been undertreated, the aberrant behaviors will disappear once treatment is adequate. Other aberrant drug-related behaviors (Portenoy), such as selling prescription drugs or injecting an oral or topical formulations, are huge red flags for addictive disorders.
Addiction is a compulsive disorder in which an individual becomes preoccupied with obtaining and using a substance, the continued use of which results in a decreased quality of life. Studies indicate that the de novo development of addiction when opioids are used for the relief of pain is very low.
The clinical use of opioids shows a difference between their clinical pharmacology and their laboratory pharmacology. What happens when opioids are given to someone in pain is different from what happens when they are given to someone not in pain.The difference in opioid pharmacology between individuals with and without pain also applies to addiction. The drug-seeking behaviour synonymous with drug addiction does not occur in patients after pain relief with opioids.
http://www.jr2.ox.ac.uk/Bandolier/booth/painpag/wisdom/lancop.html
Understanding physical dependence versus addiction.
Physical dependence is a property of various classes of drugs, including opioids and corticosteroids. Once the body has become habituated to such drugs, abrupt cessation results in a recognizable withdrawal syndrome. Full-blown withdrawal from steroids and alcohol is potentially fatal; withdrawal from opioids is uncomfortable but rarely dangerous. Some drugs of abuse are associated with a withdrawal syndrome; others (such as cocaine and marijuana) are not. Withdrawal symptoms can be avoided by tapering the drug, as every practitioner who prescribes corticosteroids knows. Physical dependence is a different phenomenon from addiction. Confusion arises because opioids can produce both physical dependence and addiction. Pain patients treated chronically with opioids often become physically dependent, but only occasionally develop de novo addiction. A prior history of drug or alcohol addiction or abuse increases the risk of addiction.
Drug addiction is a disease in which there are three elements
Loss of control (also called compulsive use) of a drug – the person uses more than intended, is unsuccessful in attempts to cut down, etc.
Continuation despite significant adverse consequences – disease or injury, job loss, relationship difficulties, arrest, etc.
Preoccupation or obsession – over obtaining, using, and recovering from the effects of the drug.
Signs of possible drug addiction in the medical setting may include:
Repeatedly using up the drug before the next refill (but see the section on pseudoaddiction below!)
Frequent requests for early refills, recurrent stories that the medication was lost, stolen, fell down the toilet, was eaten by the dog, etc.
Abuse of illicit drugs
Selling prescription drugs
Injecting topical or oral medications
Notice that the word addiction appears nowhere. Instead, the word has been replaced by the term dependency, so that opioid addiction is called opioid dependency, which is not at all the same thing as physical dependency on opioids. This is why when discussing issues of opioid addiction versus physical dependency, it’s crucial to make the distinction.
Pseudoaddiction versus addiction
In the clinical setting, undertreated patients may look like addicts, because in their efforts to obtain more pain relief they may use more than prescribed, go to more than one prescriber to gain opioids (“doctor shopping”), or make up stories why they need early refills. Behavior that results from undertreated pain rather than from addiction is called pseudoaddiction (Weissman DE 1989). Some prescribers do not realize, for example, that giving 100 Percocet (containing 5 mg oxycodone) for a month may be seriously undertreating a patient with significant 24/7 pain. If in doubt, the prescriber can give the patient a week’s supply of their pain medication at a dose that they say has worked for them, then see the patient back in a few days, along with the prescription bottle, and see what happens. In a legitimate patient who has been undertreated, the aberrant behaviors will disappear once treatment is adequate. Other aberrant drug-related behaviors (Portenoy), such as selling prescription drugs or injecting an oral or topical formulations, are huge red flags for addictive disorders.
Very well put, and soooo very true
I just finished a month long. pain management program at the University of Nebraska in Omaha ,Ne. It is really great that you have put this information on here. I am now off all pain medications(also suffering withdrawl, which really *****), I have come to understand that chroinc pain is real, there usually is no cure, and that pain medications don't help. All injuries are healed in 6 mons., anything after that can be called chronic pain. After a period of time for whatever reason, pain signals keep firing and we keep trying to make it go away. Our only control becomes medication. I have questioned so may times, "Am I an addict?" Knowing full well that I wasn't, but I needed the medicaton to function everyday. Friends and family don't understand and it leads to guilt and probably increased pain because of stress. I am still having pain, but have learned and am learnig everyday how to handle it thru the things I learned from "pain camp" Fighting withdrawl is the worst right now, but am looking forward to a bright future!
I'm One of those people you just talked about. I stopped all pain meds over two years ago (all 13 ), I use the excuse that the pain makes me feel alive. The truth is that I have 2 children at home and I don't want them to see me as weak or an addict . The new doc I have told me I have a death wish. He said that he has a good pain clinic I can join. I think the depression is getting to the point of hopelessness. My biggest fear is that my 14 and 16 year old will get into my meds if I start to take them again. How do you guys deal with meds and teens?
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MyPain, Many have been in your position. Please post your question on the Pain Management Forum and you will get many responses, at least after this weekend is over. I "hide" my medications except the few I carry on me. I have talked with those that are close to me and see me taking meds. My teenagers understand that I am not weak or addicted. Recently we went on a trip and stayed in the same hotel room. My teenager heard me moaning and crying during the night. She got little sleep. The next morning she was very worried about me and talked to me about it. I explained that yes I have that much pain apparently even as I sleep. To make her feel better I told her if that happened the next night to wake me and I would take some medication. She did and was right there with my purse (where she knew I kept my medication) the next night. She had tears in her eyes and said, "Please take something. I can't stand to hear you cry." So don't sell our teens short. If they are brought up right and I'm sure yours were, they are smarter and more understanding than we give them credit for. I still hide my meds(and fill to a smaller container) because I feel better about it and I never worry that we (she) may have misjudged a friend and they may help themselves. So do not suffer needlessly. Give your teens some credit. And if you are having problems with one of them now, there are some good keyed containers you can purchase for more peace of mind and to reduce temptation. Now make an appointment with your physician and get some pain relief, life is too short to suffer needlessly. And please post your comment and concerns for more suggestions. Take care, Tuck
I have a twenty year old son and two little girls 5 and 6 and they are very knowledgeable about my condition and why I take medications. I have always had a little metal box with a key I keep my meds in in the med cabinet and when I need to take some with me I put them in my purse which is ALWAYS out of their reach. My son has never taken my meds other than when he had dental problems and was prescribed the same med and so I gave him one of mine. He is well aware of their addictive nature and the 20 years of educating him about drugs and the destructive nature has paid off I have to make him take meds when he needs them. I would say education and keeping the meds safely put away are the best option!
Making sure you tell them why you are having to take meds and why they should never touch them is very important. You need thee meds to function and to have a life that is not trained around your pain. Your no use to them or yourself when you can only focus on the horrible pain your in. EDUCATION is key here.
I will tell you that your not any less of a mom or person because you need medical help with your pain but to get through to you is another story. We feel guilty and weak because we have to rely on meds but think if you had any other disease this would not be an issue, CHRONIC PAIN IS A DIEASE! It is a medical condition that requires medication and you need to understand and believe this is true and fact and also make your family understand this!
I would take care of the pain and see how much better things are, you know how pain affects you and your life and those around you and your being in pain is not something you can hide or deny. When your taking the necessary meds and see how much easier things are and how you can focus on your kids and family and house and hobbies you have long ago left behind because you have no room for them with having to deal with the pain you will see this is the better option and see that it is an issue you can discuss with your family and with education they too will understand and will see you need help with your pain too.
I wish you the BEST of luck and if you need some info on how to educate your family let me know:)
We have a medical condition , Chronic pain is a disease and just like any other disease you have to take care of yourself by taking the medications that your Dr prescribes. This DOES NOT make you weak nor should it make you feel guilty ever! I can not stress enough this point. Our families knows us and loves us and they also know when were are hurting and understand we need help with our pain, we may think we hide it well but pain affects every single aspect of our life even our relationships so keep this in mind and remember we are here for you whenever you need us!!!!
Making sure you tell them why you are having to take meds and why they should never touch them is very important. You need thee meds to function and to have a life that is not trained around your pain. Your no use to them or yourself when you can only focus on the horrible pain your in. EDUCATION is key here.
I will tell you that your not any less of a mom or person because you need medical help with your pain but to get through to you is another story. We feel guilty and weak because we have to rely on meds but think if you had any other disease this would not be an issue, CHRONIC PAIN IS A DIEASE! It is a medical condition that requires medication and you need to understand and believe this is true and fact and also make your family understand this!
I would take care of the pain and see how much better things are, you know how pain affects you and your life and those around you and your being in pain is not something you can hide or deny. When your taking the necessary meds and see how much easier things are and how you can focus on your kids and family and house and hobbies you have long ago left behind because you have no room for them with having to deal with the pain you will see this is the better option and see that it is an issue you can discuss with your family and with education they too will understand and will see you need help with your pain too.
I wish you the BEST of luck and if you need some info on how to educate your family let me know:)
We have a medical condition , Chronic pain is a disease and just like any other disease you have to take care of yourself by taking the medications that your Dr prescribes. This DOES NOT make you weak nor should it make you feel guilty ever! I can not stress enough this point. Our families knows us and loves us and they also know when were are hurting and understand we need help with our pain, we may think we hide it well but pain affects every single aspect of our life even our relationships so keep this in mind and remember we are here for you whenever you need us!!!!
Drug addiction is a disease in which there are three elements
Loss of control (also called compulsive use) of a drug – the person uses more than intended, is unsuccessful in attempts to cut down, etc.
Continuation despite significant adverse consequences – disease or injury, job loss, relationship difficulties, arrest, etc.
Preoccupation or obsession – over obtaining, using, and recovering from the effects of the drug.
Wow that was me to the T....Knowing this about myself means that i have to find another way to deal with the pain i've dealt with every day for years. Though it hurts to stand and it hurts to sit and i can barley hold a peice of paper without dropping it after 30 seconds....I must find another way because i am an addict.
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