Is there a difference between dependence & addiction?

[The_Me_I_Want_To_Be]

My first real post here and I hope I don't offend anyone. I just don't want people to judge me or hate me for not admitting to being a drug addict...because I never really considered myself being one. I don't take drugs recreationally...never felt "high" from my pain meds...just made me feel normal...so I could function without so much pain from my Fibromyalgia, CFS, RLS & Arthritis (among other things).

I was told it was considered dependence, not addiction, if a patient/person takes medication as prescribed...not for recreational use...when needed for chronic pain that after years of dosage tolerance and changes begins to get to a point where you've realized you've become dependent on a drug that used to help you function, but now either requires going to a stronger pain med or putting on the brakes and starting anew...figuring out just how bad life would be without Hydrocodone & the occasional Oxycodone during flare-ups, when it doesn't seem to be all that grand with it...still in a lot of pain...physically, emotionally & spiritually. And, as my nickname states, it's time to be "The Me I Want To Be" and not this person I've grown accustomed to for so long!  

I'm having a really tough time right now coming off this stuff...pretty much went from 6-8 tabs of Hydrocodone/APAP (5mg/500mg) daily down to none in the past 1 1/2 weeks...actually thinking I was going to be getting another refill so I could taper off a little more slowly, but my new doc here in AZ decided to leave me in a lurch with no advice or help what-so-ever. I have 2 tablets of 20mg Oxycodone ER left that I've been trying to hold onto in case I'm in such excruciating pain with the detox, it may be helpful to use them??? Fortunately, my old doc from the Midwest did tell me that Benadryl helps with the shakes & nausea, Immodium helps for obvious reasons, lots and lots of water & rest, warm baths/showers/whirlpool, and what I found strange was 10-15 minutes of light exercise/stretching each day will help too...though I haven't been up for that quite yet...my nerves and muscles have been firing at each other for 3 days straight now and the mere mention of food makes me sick. Any help or support would be very much appreciated!

Thanks!--Andrea

[Rose703]

Dependance=a person who takes pain meds as directed but the body will become used to those pain meds and would have w/d's if taken away abruptly.

Addiction=a person who may or may not be prescribed pain meds but in either case they're abusing them. Such as taking more than prescribed, crushing tablet, snorting meds, and shooting them up.

To me BIG difference. I would talk to your old doctor and get him in the loop as to what you're going through in AZ.

So sorry hun that you're being put in this position by a doctor who apparently has no clue how to handle narcotic pain meds. I would also be looking for another doctor in AZ who will help you.

[kittykat58]

I also never quite understood the difference between addiction and dependence either -- but I think the difference is as follows:

dependence means you develop a tolerance to the medication and experience wd symptoms w/out the drug. you use the medication as prescribed, sometimes at higher doses due to tolerance, but still as prescribed.

addiction means that you have the same condition(s) as above, but are taking the medication other than as prescribed, either to get "high" or even to feel "normal", and are resorting to socially unacceptable and/or illegal means to acquire the drug: doctor shopping, lying on the internet to buy the drug, buying on the street, forging prescriptions, stealing meds, trading or selling personal property (and even sex) to get the drug; losing personal property (home, car, etc) as a result of acquiring and/or abusing the drug; losing close relationships b/c of drug use; changing your social contacts as abuse progresses; changing activities (for the worse) or losing interest in healthy activities b/c of drug use (ie, dropping out of school, increasing drinking and/or other drug use to cope w/ wd symptoms, dropping hobbies, etc) -- this sort of thing.

I think that this distinction made the most sense to me.

[kittykat58]

diclofenac is available in this country by prescription only. it is an NSAID (and non habit-forming). it can be gotten w/out a prescription from australia/new zealand/canada online as "voltaren" (be careful with that on-line pharmacy!!):

http://www.pillsbasket.com/item.php?id=4040

this site looks like it has a gel -- could be very helpful with the above-stated use:

http://www.getpharma.com/lifeproduct.asp?deptid=582&mainlink=pharmacy

this rapid release 12.5mg is what I used when overseas (and I have ordered it here on-line) -- I think it's a great product for arthritis/joint pain:

http://www.netpharmacy.co.nz/65/group/307/page/1/style/117/Voltaren+Rapid+125mg+Muscle+And+Back+Pain+Relief+10+Tabs

good luck!
kittykat58

[worried878]

I am sorry you were left in a lurch....your new doctor could have been audited in the past as often happens and they have to justify narcotic prescriptions they write..they get paranoid and will start tapering their patients off or in worst case scenarios..cut them off..your old doctor may have gotten audited one day and the same thing would have happened....they come in and look at their charts and long term narcotic rx's are only allowable in certain circumastances...fibromylagia/arthritis is not an indication...a doctor in my clinic was audited last week and they audit them all the time down here...it is very difficult to get long term rx's for that dose daily around here...they are strict and the doctor's are cautious...at this point i am glad of this as i could have ended up using more daily than i did..narcotics are meant originally for acute and not a long term solution to chronic pain due to the tolerence..i just helped him with this audit and learned alot from it...what is your plan at this point?

[addictedme]

Definintly a differance. Anyone taking opiates,even as prescribed for a length of time will become physically dependant on the drug and although the physical wds will be the same the problem for the dependant was just that,,,a physical dependance.Addiction on the other hand is a desease that effects every aspect of the addicts life,,drugs,no matter what kind,legal or illegal are just a symptom of addiction and rather you think addicts are born or become addicts there addiction started long before they used drugs. Thats why private counsling,group therapy,etc. are essential in getting to the root of the problem. Many times when people think that drugs are their problem they"re able to stop using drugs but then there addiction plays out in other ways like gambling,sex,shopping,etc.The best way to start is to learn about the enemy(addiction) and use every option available to combat it like you would any desease.Once you have a solid foundation for your own recovery then the feeling you get from helping others is better then any feeling you got from drugs,,,gl to ya

[beach777]

Sweetie,
Absolutely there is a difference between physical dependence and substance abuse. I take it from your post that you recently moved to AZ. and your new doc doesn't want to treat you with narcotics like your prior doctor. That's his perogative I guess (probably got his MD in a third world country b/c no informed doc would just drop you cold turkey from vicodin with your physical ailments.....sorry, showing my bias against ignorant *** doctors but I'm an attorney and I get paid to put their sorry ***** in jail. CALL your doctor in the midwest, tell him you haven't found a doctor to treat you yet and you need him to call you in some vicodin. The dosage you're taking is minimal.
Yes, you are physically dependent and the withdrawals will be the same as for an abuser BUT your pain IS going to come back. It's real and you're as entitled to treatment for that pain as much as a diabetic is entitled to insulin. Sweetie, if you were an addict, you wouldn't be on vicodin, you'd be taking something with a real kick.
Good luck. I say get treatment and you will be the me you used to be---- maybe even better----if its the result of narcotics well then Thank God for Purdue pharmaceuticals. Don't hurt b/c you have labeled yourself. Goof luck

[The_Me_I_Want_To_Be]

Lucy,

Thanks for the info on the home remedy. I'll do a little research on the diclofenac and will see if I can find that through my doctor/pharmacy. I've tried a lot of homeopathic/alternative types of remedies over the years. Some things I've found helpful...others not so much. Being that I've got so many ailments, it's hard to cover all the bases with just one or two things (unfortunately). Let me know how the treatment works for you and I'll keep you posted if I can make it work for me too.  Thanks hon!
--Andrea

[Missouri_Girl]

Hi Andrea.  I have been taking Vicodin (Hydrocodone/APAP 5/500) for only about 6 weeks now for a serious leg injury, and I also do not feel any kind of "high" from it.  I only feel pain relief.  I started out on Percocet at least 4X a day for the first two weeks, then stepped down to Vicodin, 2 pills 3X a day.  My doctor prescribed the Vicodin for 1 pill, but I found that it wasn't doing anything for the pain, so I bumped it up to 2.  I figured it was because I had been accumstomed to the strpmger Percocet.  Anyway, even in the short amount of time I have taken the Vicodin, I can already sense a little bit of a "withdrawal" feeling if I decide to go a day without any, albeit very minor compared to what so many on the forum are facing.  It just seems so crazy, doesn't it,  that a pain med that is prescribed so often for legitimate pain becomes a dependency?  This morning I took Advil instead of the Vicodin, and that seemed to help a bit, so I"m wondering if Advil might help you out some.  And I too found that when I went for a walk in the sunshine with my dog (well, not exactly a brisk aerobic walk w/the recovering leg), and that really seemed to be helpful.  A great glass of iced tea seemed to help me for some silly reason today too!  Sometimes it's the little things.....:)  I find that when I reward myself for very small accomplishments, that it really lifts my spirits and makes me feel good about myself.  For me, it's often a Starbucks Carmel Latte!   Anyway, keep up your great work, and I can tell you're definitely going to make it!

[CadillacJack]

To: Want to be:

I'm not an addict either. At least I used to tell myself that. Truth of the matter, many folks got here on the same terms that you have. I you are dependent, you are addicted to that substance. It's like this equation: If all ducks are birds the all birds must be ducks. If B=D, then D must equal B. I'm too green to give advice on how to quit. I merely know what seems to work for me. Here's the undeniable sum. You can't take the stuff for the rest of your life. Quit while you are at your strongest, which would be right away, no doubt. Good luck to you. There are people on here who will help you figure out the best way for you to quit, if you want to.

[lucyred68]

oh hun, i so feel for you.  whether dependence or addiction does'nt matter when you are withdrawing.  been there, done that, got the t-shirt.  your body does'nt know the difference.  do you have access to diclofenac?   it is an anti-inflamatory med with no addiction problems.  i was just given a recipe for mixing it witha lotion and rubbing it into the skin to relieve pain.  trying it right now.  if you can control the pain with something like that, after the wd's, and even during, it would be great.  if you can get them, barely cover 20 75 mg pills with water.  or 30 50 mg pills if that is what you can get.  let them set over night and disolve.  stir really well, then mix with 1 cup of your favorite lotion.  rub on your skin wherever you want, generously.  the woman got the recipe from her dr, it isn't a home-made thing.  a pharmacist will make it for you, but they charge a lot.  hope this helps with the pain issue, as you don't need to be taking it orrally when you can't face food.  as for the food problem, try to eat some bananas, drink fruit juices and gatoraide to keep from dehydrating.  you need some nutrition, but that will come when your wd's are lessening.  take lots of hot baths with epsom salts for the pain and restless legs.  i'll be praying for you,   Lucy