Addiction VS physical dependence of narcotics

[NurseTracy]

I have been reading a lot of posts by people claiming to be addicted to their pain meds because they have withdrawl symptoms if they don't take them. PEOPLE, addiction is a psychological behavior where people consume the narcotic after the illness/injury has healed and pain has subsided. Addicts take these meds for the euphoria they produce and not for the control of acute or chronic pain. NOW, narcotic dependence, meaning someone takes the narcotic for pain in order to live some semblance of a normal life with limited pain, will cause withdrawl symptoms if the narcotic is either drastically reduced at one time or stopped all together. Dependence does not usually require any form of treatment or withdrawl program, in a hospital or at home, unless that dependence is bordering addiction.

Please, people, understand your medical conditions and your use of medications. There is no need to suffer because you depend on a medication to live.......after all, if you had to depend on insulin shots ( for diabetes) to live you would take those shots, right?

I'm not trying to sound condescending or like ya'all are idiots, etc.......you are very smart people but many times people, doctors included, don't explain the difference between dependence and addiction and will even use these words interchangeably. Learn the difference.......you don't need to suffer needlessly!

From one chronic pain patient to another.

[Mollyrae]

Well, well said. Thanks for the reminder.

Mollyrae

[Jinx_777]

are you addicted if you take more than you are supposed to (breakthrough pain med) NOT because you are seeking a high, but because you are in pain?  that is why i think i am considered an 'addict' because i haven't always taken the breakthrough meds as prescribed due to severe pain flare

[gungalmama]

I am dependent on pain medication to control my facial pain so I can function at all. I would say I have a physical addiction if I stop but if they said today "We figured it out after 8 years and tens of thousands of dollars!! THIS will fix you...." and I would be out of this daily...hourly hell then I would HAPPILY NEVER take another pain pill. EVER.
Since they have not figured out the problem...even though they make thousands of tests and guesses and different medications they can't fix me....but they don't want to medicate my pain either.
It is at the point where I am thinking of seeing a pot doctor even though I have never used it(really I am that ONE person in CA LOL) If I could get my mind around the stigma of using it. I am not afraid of become addicted to it either but my quality of life should not be dictated by the DEA and fearful doctors that are willing to take my money and then send me on my way with "I dunno...try this doc...pills for pain? OH NO we don't do THAT."

I WISH I could give them my pain for 3-4 days. Is that mean?
Maybe but if every doctor and dea ******* had to live a few days with sever chronic pain....anyone that is involved with regulating them....we would have better pain management laws.

[Mollyrae]

I must add that I am a chronic pain sufferer and do not use opiates for the pain. I treat it in other ways. However, I do know a host of ppl that if they stop their meds, life also stops for them. I see this in my group everyday.

Molly

[Mollyrae]

BOY, you are way off base with your opening comment. Some ppl have chronic pain that does not let them just stop taking their meds. People that do not have chronic pain do not realize what it's like. So until you do, there is no place for that type of comment.

Mollyrae

[tiredofthetabs72]

7 days off pain meds today, and pain is manageable, far from gone, but better than with taking norco, it just stop working. So since 2008, 1st time off meds. I thought I needed them to function, well not so, did all kinds of things in the last couple of days, without a pain pill!!!

[mommyneedingadvice]

I posted above question on this thread and now realize I should probably have had started new one.  I will repost as new question too.  Just in case you see this twice and wonder what I was doing.  Thank you.

[mommyneedingadvice]

I don't know if anyone can give me answers per say, but thought some people would have some insight.  I've never posted anywhere.  So here goes...

I am 31 weeks pregnant.  I have severe pain that is requiring surgery  and I was scheduled to have it done in January, but in December had an unexpected pregnancy.  My husband and I are happy, however, I can barely walk and have been on an increasing dosage of hydrocodone and now maxed out on 10 pills a day of  10/325.  My OB doctor this week wants to switch me to oxycodone as it is stronger.  I refused.  Don't get me wrong, the meds help, but I am definently physically dependent.  If I go over 10 hours (sometimes just 7-8 unless its just I my head) without a dose, I am VERY anxious and can't sleep, am sweating, stomach cramps, (diarehhea a few times I tried skipping a dose).  My tolerance has gotten too high for meds to work well and I feel it is time for me to get off of these.  My OB doctor does not think now is good time as pain is only going to increase.  I have appointment in October already scheduled with surgeon again (this will be month after baby is born) to get surgery planned again.  The past few weeks I have been taking meds closer together, sometimes 2 1/2 hours as they wear off so fast with the little relief I still get from them.  I get so frustrated that they won't work and that is why I want off. Its either get off, overdose myself (which isn't an option.....hence why OB wants to go to oxycodone which I have never been on).  My baby is likely going to have withdrawls too and my doctor and the pediatrician I am working with are expecting that and said they will be able to give him medications and get him off them.  I could just cry.  Why is this happening to me?  I can't ever get comfortable and pain is worse, likely from weight of baby and pregnancy, but I can't see any reason to continue meds that don't work.  How can I get off these WITHOUT withdrawls?  How fast to taper?  Since the medicatons are not working well, maybe I could get off or at least decrease amount in next 2 months so my poor baby won't have too many withdrawl problems.  I have been on bed rest mostly anyway last few weeks as I can't walk well.  I just can't CAN'T take stronger medication being pregnant even if it means just lying here in pain waiting for baby to come. I have been on medication for a year...or just about.  Total daily hydrocodone is 100 mg.  Ideas on getting off without getting sick or having such awful anxiety?  I don't  want to take anxiety meds.....like Xanax I have read is helpful....while pregnant either.  

Thank you for help in advance.

Sue

[BokehGirl]

Thank you. Well said. I am new here. So READY to be off Methadone for Chronic Pain! Am also a Hospice RN and CD family counselor/interventionist.

Walking the Chronic Pain path with hope for a Methadone - free future.

[NurseTracy]

Thanks. I will find where I was...LOL. It is now popping up on the pain forum.....??? Whatever, I think I will find it. I have read so many.

[ROSYouralright]

Yes .. Just go to the substance abuse forum where you first posted & just let everyone know that your on day 1 CT and you will be supported & encouraged through this. CONGRATULATIONS on taking your life back!

[NurseTracy]

PS, what are you talking about " denial?" I'm not in denial of anything. Maybe you could tell me what I am in denial about. Not ONLY addicts will try go off narcs CT. Maybe you just aren't familiar with all this? I mean, anything but an addicts view.mi don't know, just guessing.mim not here to fight with anyone, just wanted to give some real info and ask for support for myself from those who have gone thru this or are going thru this. I'm not a bad person, you know! I also don't think addicts are bad people. We are all, no matter our backgrounds, human beings and deserve to be treated with RESPECT & DIGNITY.

[NurseTracy]

Are you talking to me? I don't want to live my life on narcotics. I was off of them for some time and had to go back on for medical (pending surgical) reasons. Since I don't want the surgery, read what I wrote to ROS, I don't want to stay on the meds. I am going CT because I just don't want to go back in for another Rx. My doctors know everything and know what I am doing as I just talked to him about it 3 days ago. I was on a low enough dose then that he is ok with this hence the reason he gave me clonidine.

It doesn't matter if a person is dependent or addicted, the withdrawals are the same. For me it is a personal decision. It's too easy to take a pill when you are hurting so badly and that is why I don't want them. That does not make an addict.....it merely makes one who doesn't want to be putting poison in their body. I have absolutely no idea, with the pain I have, if I will never be on narcs again, but I have to try......for myself.

[NurseTracy]

Absolutely I will! Tell me how to get there.....I am quite new. In all honesty, ROS, since being back on narcs for severe pain, today is my number one day of being off again. I was put on them last may for SI joint dysfunction and told I need another fusion.....my other SI joint has been fused already. With the pain I am having with that one, I am not so eager to have it done again & am looking for other options.its a long story but all in all, I do not want the surgery again! And I do not want the narcs anymore.

[msdelight]

I am utterly confused by all of this. If you are a chronic pain patient who is not addicted but ONLY dependent, then why are you going cold turkey? What is it that you know that the doctors don't? How is it that on day one you are not humbled by these demon drugs, but instead in denial. Just wondering.

[ROSYouralright]

Today is day 1 huh?? Will you come to the SA forum and post about it? You will get TONS of support...

[NurseTracy]

I totally understand the effects of addiction. I thought I was there myself and took major steps to get off the narcotics myself as I believed they were going to kill me. I went through the Rapid Detox program in michigan and it was the best money I ever spent. I don't overuse my medication now but I still want off. See, before I was taking more meds (hydro) to get the pain under control as it quit working and where I am from, doctors don't readily change your rx. It's crazy as with being on a med for chronic pain many build a tolerance to that med. that, in and of itself, is a vicious cycle!

I apologize to you all for starting this post in the addiction forum.....I was unaware as I am new. I also found a lot of confusion in this forum between addiction and dependence. In any case, I would like to stay here as I am starting a CT withdrawl and need the support. Today is day number one of NO narcotics although I do have some meds like clonidine to help some. My doc gave them to me. I fear the severe RLS as I don't only get it in my legs but my arms as well.....to me, that is like the worst part of this! Ok folks.......here we go!

[dominosarah]

When we have a new member come to the addiction forum such as yourself we ask a ton of questions.  We feel each one out to see where they are at in terms of being dependant or addicted.  We arent afraid to give them the link to the Pain Management forum.  We are all very aware that some people will need pain meds but for most of us we have to have total abstinence, along with a recovery program, a plan in place if we ever have a medical condition that will require pain meds etc.  Our lives depend on all of this as death is a guarantee if we dont follow our plan.  We also know what a sly cunning and baffling thing addiction can be and it can grab you before you know what hit you~

[ActingBrandNew]

"There are many aspects of addiction and also many aspects of dependence. Each person has to be evaluated for their case and not for the stigma of narcotics use......does that make sense? "

Yes...it makes total sense.

I think its confusing to many people when a person with just a dependency issue goes and posts on an addiction forum. Even if a person takes pain pills as prescribed for many years and then decided to get off the...he or she will experience withdrawals. I do agree in the fact that if a person is taking opiates as prescribed by the doc and they are not being abused and they improve the quality of life than by all means...a person should continue treatment even if there is a dependency issue.

Maybe I didnt read the original thread...I came in a little late and just saw your post explaining the difference between the addiction and dependency and was confused as to why on an addiction forum. Well...as you can see this thread is now in the pain management forum which I think more appropriate.

I wish you the best in your quest to get off hydros. Take care.

[NurseTracy]

I started a new thread because the ones I was reading about actual CP patients was an old one. All I see is, " this post is old so please start another one." I know a lot of people here are addicts but there are quite a few CP patients that are complaining about getting of pills they have never overused, abused, etc......normal dependence. I also have to disagree with Kyle, I think, who stated addiction is just a small step from dependence. That all depends on the reason people take the narcs. Is it only to relieve pain? I have had many dependent patients that never turned into addiction. My mother is one of those people......on meds over 20 years.......addiction is not even a concern. I do feel that even tho a lot or most of the people here are addicts, some don't appear to be.....in my professional opinion......they appear to be dependent as they can live a better life with the meds. There are many aspects of addiction and also many aspects of dependence. Each person has to be evaluated for their case and not for the stigma of narcotics use......does that make sense?

Like I said, I am not here to belittle anyone.....God knows I am not perfect and I would like to come here for support as I am getting off hydros taken for a back injury that has not been fixed. I just feel some alternative therapies might work.....only time will tell. So, please don't hate me for bringing this up.....it was just some factual things I brought to light trying to help.

[NurseTracy]

ROS, I totally see where you are coming from. I should have clarified the low percentage of addiction happening is actually among chronic pain patients. Do the research, you would be surprised. Now, a lot of people have predispositions to addiction and that is different than from people who don't have it. There are many factors but, my main goal here was informing the difference between addiction and dependence. Addiction DOES NOT mean a person is a bad or worthless person. It's a disease that needs to be treated. I have been on the end of dependence and am so sick of feeling like a slave to pills. I am going CT tomorrow from 6-8 hydrocodone 10mg tomorrow. I will be here for support and I'm not here to judge anyone.....quite the opposite. I am hoping we can all help eachother with remedies, etc.

I just hate seeing literal pain patients refuse pain meds and suffer needlessly because they are afraid of addiction. It's a scary thing to feel and I understand it.....unfortunately, not all CP patients understand the difference between dependence & addiction. Education needs to be foremost from the docs instead of just telling the patient, " these are highly addictive pills." That scares the H out of people.

[ActingBrandNew]

You said,

"but 7yrs on I take these tablets with no pain n more then triple the recommended dose, my mind thinks of nothing else but how to get my hands on more pills.... I then buy them from a supplier or pester people I know who have them to let me have some, I take usually 7 at a time coz I like the feeling!"

You are taking 3X the regular dose. You say all you think about is how to get more pills. You get them off the streets and you take them because you like the feeling.

I will tell you....you are an addict. This is addiction.

You are in the right place though if you want to get clean.

[ActingBrandNew]

Your post/topic will be most effective if you simply respond to a thread in which it applies to. The majority of people on here are addicts that use anything from heroin, meth, pain pills, to cough syrup. But...there are some who weren't abusing them but still come here because they are physically dependent and want to know easier ways to cope with the withdrawals. They are welcome here too. You say you are not trying to sound condescending or like were idiots but Im afraid it does. Just being honest here. We pride ourselves here on MH with how supportive and knowledgeable we are when it comes to recovery and addiction. We have years of recovery on this forum. When people come here on an individual basis asking the question if they are dependent or addicted...we address the issue on a personal basis and try to help that individual figure it out.  Its pretty simple to be honest...it doesn't take much rocket science...just a little good ole fashion soul searchin.

[kyle505]

My personal definition of being addicted to something is when that "something" becomes more important than any other aspect of your life - health, family, job...Everything comes second to your "something". I'm not a medical professional, just an addict, but it sounds to me like you are at least an abuser, dependent on the drug, and from there it's a very short step to addiction. Like Vicki said, you decide, we can't. But we can offer advice and support.
K