Hey:
I just read this on another thread...that someone considers dependency very different from an addiction. I really don't know anything about this. I would be
very interested in hearing varying points of view on this topic.
Thanks...and happy holidays!
Sarah
Hey Ms Darlin Sarah...(got your email btw, will write soon)
This subject always confused me as well but the way I feel about it is that you can be physically dependant on pain meds without being mentally dependant. I think that your body is addicted to them because of long term use but that not everyone is "mentally" addicted. Not absuing them etc.... My mother is a good case in point. She has used Vicodan for a very long time because of chronic pain but does not have addictive qualities or tendancies. She does not take more than prescribed, usually less, never runs out, doesn't lie to get them blah blah blah....The pills do keep her comfortable which gives her quality of life but have taken over her life. She can't function without them. Rock and a hard place I guess....
Does that help?
xxoo
This subject always confused me as well but the way I feel about it is that you can be physically dependant on pain meds without being mentally dependant. I think that your body is addicted to them because of long term use but that not everyone is "mentally" addicted. Not absuing them etc.... My mother is a good case in point. She has used Vicodan for a very long time because of chronic pain but does not have addictive qualities or tendancies. She does not take more than prescribed, usually less, never runs out, doesn't lie to get them blah blah blah....The pills do keep her comfortable which gives her quality of life but have taken over her life. She can't function without them. Rock and a hard place I guess....
Does that help?
xxoo
Sarah-I copied this from a thread sarted last week.
DRUG DEPENDENT VS> ADDICTION
by Harold G.Koenig,M.D.
It is important to distinguish addiction from physical dependence because these two terms are frequently confused.Addiction occurs when an individulal seeks out a drug,has negative consequences resulting from the use of this drug,and uses more and more of the drug than originally intended.Its effect to mask feelings,enhance feelings or change feelings is the primary driving force for continued obsession.
Physical dependence occurs when a person has been taking a drug for a long time and his or her body becomes used to the drug
Although addiction is associated with the need to take more and more medication to achieve the desired effect,people in chronic pain who are physically dependent on a medication sometimes need more medication because the pain at the lower dose was under-treated.These are not drug addicts. but simply people with chronic pain who are dependent on the pain medication and need more of it for adequate pain relief."
DRUG DEPENDENT VS> ADDICTION
by Harold G.Koenig,M.D.
It is important to distinguish addiction from physical dependence because these two terms are frequently confused.Addiction occurs when an individulal seeks out a drug,has negative consequences resulting from the use of this drug,and uses more and more of the drug than originally intended.Its effect to mask feelings,enhance feelings or change feelings is the primary driving force for continued obsession.
Physical dependence occurs when a person has been taking a drug for a long time and his or her body becomes used to the drug
Although addiction is associated with the need to take more and more medication to achieve the desired effect,people in chronic pain who are physically dependent on a medication sometimes need more medication because the pain at the lower dose was under-treated.These are not drug addicts. but simply people with chronic pain who are dependent on the pain medication and need more of it for adequate pain relief."
Hey Miss Darlin Lisa! hahaha
Yes it does...thank you! One thing I was questioning was: Does the dependent person ever get to the point that a "normal" dosage won't work for them anymore...or does that just happen to the brain of an addict. What exactly is it in our brains that changes us to become addicted?
I guess it was on that "Why did you start using" poll thread that this came up. I know for me, I was prescribed them...and for years, it was just ten a month, during "that" week...and often, I didn't take all ten. Didn't "party" on them because when I was taking them I was too sick to do anything but sleep...hot baths, sleep, etc.
When did that become not enough for me? And, at that moment did I become an addict??? I am just curious about this. Make any sense?
edited to say: oooops Tim! as usual, I spoke too soon! Thanks!
Yes it does...thank you! One thing I was questioning was: Does the dependent person ever get to the point that a "normal" dosage won't work for them anymore...or does that just happen to the brain of an addict. What exactly is it in our brains that changes us to become addicted?
I guess it was on that "Why did you start using" poll thread that this came up. I know for me, I was prescribed them...and for years, it was just ten a month, during "that" week...and often, I didn't take all ten. Didn't "party" on them because when I was taking them I was too sick to do anything but sleep...hot baths, sleep, etc.
When did that become not enough for me? And, at that moment did I become an addict??? I am just curious about this. Make any sense?
edited to say: oooops Tim! as usual, I spoke too soon! Thanks!
It was explained to me once that an addiction is a behaviour we have no control over. Dependency is "becoming dependent" on something but we have not lost control over. "Tolerance" is another word that gets intertwined with addiction and dependency. Due to body size, weight, chemistry, we all can "tolerate" a different amount of a substance (be it food, drugs, alcohol, etc.) Time will also alter our tolerance. When 1 pill every 4 hours once worked for pain, it then becomes 2 every 4 hours, etc. So we build a "tolerance" as to how much of something we can take. For awhile we may all kid ourselves that we just have a higher tolerance, or we have become dependent but we are not addicted. Call it what you want, but if you are "dependent" on drugs and your "tolerance" has increased significantly, and you will lie, cheat or steal to support this "dependency" or "tolerance" WAKE UP - You are addicted. In other words, if you no longer have control over this substance, you are addicted.
I think for me...I distinctly remember not calling my physician for an rx, because I knew I didn't really need it. I could have gotten it, but I didn't want to do that. So, I bought them from someone who had a refill every month, etc. (You know the rest of that story!)...Anyway, that was it for me. I never ran out of them from that moment on...and that not calling my physician "morality" went right out the window too!
I think I am safer thinking the word addicted than playing a mind game with myself...of just being dependent...like there was more room to go in my little game. That could be dangerous for me.
Thanks Donna!
S.
I think I am safer thinking the word addicted than playing a mind game with myself...of just being dependent...like there was more room to go in my little game. That could be dangerous for me.
Thanks Donna!
S.
Sarah,
Isnt it amazing how semantics can change everything? There is no sugar coating the fact all of us here are addicts, no matter how it began. Im glad my words were of help to you :)
Isnt it amazing how semantics can change everything? There is no sugar coating the fact all of us here are addicts, no matter how it began. Im glad my words were of help to you :)
Sarah. you said: When did that become not enough for me? And, at that moment did I become an addict??? I am just curious about this. Make any sense?
When it became not enough for you is when you started using them for anything other than pain and not in the way in which they were prescribed. For me, it became when I started using them to not feel anything, emotions etc...
I think you make perfect sense and what a great thread! As always, Tim answered it best.
xxoo
When it became not enough for you is when you started using them for anything other than pain and not in the way in which they were prescribed. For me, it became when I started using them to not feel anything, emotions etc...
I think you make perfect sense and what a great thread! As always, Tim answered it best.
xxoo
Quite an interesting topic and one open to much interpretation it seems. We have many here in chronic pain but their use of pain medication has been frowned upon. I never got that. But I do think that anyone who has been on pain medication for a lengthy period of time and cant function without it, is indeed addicted. Does calling them dependent make it sound better? Once our bodies become adjusted to functioning with these drugs, its a battle for anyone dependent or an addict to function without them. Getting clean is alot easier for those of us who dont actually NEED pain medication. Those who DO need it have quite a battle. Its not like cigarettes which are good for nothing. Painkillers have their place but unfortunatley in time all users become tolerant of them and need to increase their dosage. Many of us became addicted for our own stupid reasons but many here also became addicted because of true pain that needs relief to even function.
I have a friend whose mother has taken pain medication for years for a neuralgia condition. She fell last year and broke her pelvis...through the course of that treatment, her Dr. recommended that she go into a rehabilitation facility to regain her strength, etc.
While in that facility, her therapists realized she had a pain medication addiction and it was interfering with her physical rehabilitation. She began treatment for the pain medication addiction as well and once off those, her physical rehab went 100% better.
Now having completed both some months back, her entire life is back on track. As her daughter said...who knew? Well, I did! Anyway, her mother was very pessimistic and negative before getting off the pain meds, and very limited physically...Being free of the pain medication has helped her regain both life force AND real energy. She is actually OUT of a wheel chair for the first time in years. (she was in a chair most of the time prior to breaking her pelvis)
I am sure that her family would say dependent...but really, what is the difference?
While in that facility, her therapists realized she had a pain medication addiction and it was interfering with her physical rehabilitation. She began treatment for the pain medication addiction as well and once off those, her physical rehab went 100% better.
Now having completed both some months back, her entire life is back on track. As her daughter said...who knew? Well, I did! Anyway, her mother was very pessimistic and negative before getting off the pain meds, and very limited physically...Being free of the pain medication has helped her regain both life force AND real energy. She is actually OUT of a wheel chair for the first time in years. (she was in a chair most of the time prior to breaking her pelvis)
I am sure that her family would say dependent...but really, what is the difference?
If your only dependant once through withdrawals your all set, if addicted it becomes more complicated phsycologically and you need some form of treatment.
Hey there John Dee!
Many moons! Happy Merry to you!
Many moons! Happy Merry to you!
Hi Sayruh, Happy Holidays to you too.
There are probably MANY people out there taking pain medication as prescribed by their doctor who have no idea they have become dependent on them. Only when they need to alter their medication for some reason would they then know what we know. Sarah, I can see that sitation happening quite often, especially to elderly people who would not for a second consider themselves an addict. But I can also see JohnDee's point that one who has just build up a tolerance but then stops probably does not have the psychological problems one who is a true addict would have.
I bet....just mo....that the "reason" for taking them has a lot to do with that also.
For instance, if I only took them for legit pain management, and then came off, withdrawal and all....would probably never think I was an addict.
Fast forward to taking them for the zing....and knowing I was an addict before I ever tried to quit. No doubt in my mind...I was addicted at a certain point.
Like you said Donna...semantics!
JOHN DEE: Hey, have you heard from our Carolina Girl lately? If so, tell her I am about to release the blue ticks...and that howling will keep her up all night....so she better check in!
For instance, if I only took them for legit pain management, and then came off, withdrawal and all....would probably never think I was an addict.
Fast forward to taking them for the zing....and knowing I was an addict before I ever tried to quit. No doubt in my mind...I was addicted at a certain point.
Like you said Donna...semantics!
JOHN DEE: Hey, have you heard from our Carolina Girl lately? If so, tell her I am about to release the blue ticks...and that howling will keep her up all night....so she better check in!
http://en.wikipedia.org/wiki/Addiction
Lots of information here. I think the distinction between the two has to do with behavior and intent. Physically dependant people don't doctor shop or buy drugs on the street. If the pain is not being controlled, they go to the doctor. When the pain subsides or the doctor discontinues pain meds, they stop taking pills. They still feel physical withdrawal, but they don't continue taking them.
My FIL has been through many major surgeries in the last 4 years, many of which have required long hospital stays and long periods of time on heavy pain meds. He doesn't like taking them and when the pain subsides, he stops. He goes through withdrawal while meds sit on the table beside him, untouched. After withdrawal, the pills are forgotten. If he has a pain flare up later, he goes back to the doctor rather than reaching for the pills. Usually, he just gets another prescription for the same thing, but he didn't self medicate, he went to the doctor. Sometimes they will give him non narcotic meds, and that's what he takes. I've seen him in extreme pain because OTC meds aren't working, yet it never occurs to him to reach for the percocet in the back of the cabinet.
Addicts don't do this. They self medicate and take meds for energy or emotional pain or to just have a better day. They seek opiates for pain that could be controlled by something else. Bottles don't sit on their shelves untouched for months. Among other things.
I think the lines can cross sometimes, and it's not all black and white, but there is definitely a distinction between physical dependency and addiction.
Lots of information here. I think the distinction between the two has to do with behavior and intent. Physically dependant people don't doctor shop or buy drugs on the street. If the pain is not being controlled, they go to the doctor. When the pain subsides or the doctor discontinues pain meds, they stop taking pills. They still feel physical withdrawal, but they don't continue taking them.
My FIL has been through many major surgeries in the last 4 years, many of which have required long hospital stays and long periods of time on heavy pain meds. He doesn't like taking them and when the pain subsides, he stops. He goes through withdrawal while meds sit on the table beside him, untouched. After withdrawal, the pills are forgotten. If he has a pain flare up later, he goes back to the doctor rather than reaching for the pills. Usually, he just gets another prescription for the same thing, but he didn't self medicate, he went to the doctor. Sometimes they will give him non narcotic meds, and that's what he takes. I've seen him in extreme pain because OTC meds aren't working, yet it never occurs to him to reach for the percocet in the back of the cabinet.
Addicts don't do this. They self medicate and take meds for energy or emotional pain or to just have a better day. They seek opiates for pain that could be controlled by something else. Bottles don't sit on their shelves untouched for months. Among other things.
I think the lines can cross sometimes, and it's not all black and white, but there is definitely a distinction between physical dependency and addiction.
Atlasgirl.......Herowoman!
Thank you Atlas.....GREAT INFO!
Happy Merry to You!
Sarah
Thank you Atlas.....GREAT INFO!
Happy Merry to You!
Sarah
There is a difference between PHYSICAL dependency and PSYCOLOGICAL addiction. I think Sarah's first post asked the question WHEN did the change occur. And she probably answered her own question. MOST of us here, I would venture to say, are addicts. We are too mentally entwined with pills. But I think there are far too many addicts out there who dont know it. They suffer the withdrawals when they are out. They just dont recognize what they are. My father in law has been prescribed painkillers through the years for a variety of problems - broken food, kidney stones, knee surgery, etc. I use to refer to him as jekyl and hyde - over the years its become obvious why. He also has a medicine cabinet with cough medicine with codeine for his "bronchitis" year round. In my own mind, I think he has become more than physically dependent on the substances. I think the line between becoming physically dependent and becoming addicted is a very very fine line at best.
This was always very confusing to me but today I do believe there is a difference.I also do not think that everyone who comes here or even goes to NA their first time is an addict.They may indeed be drug dependent.
My understanding;
Physical addiction is a biological occurence with extended opiate use.It wouldn't matter who started using them.The intrinsic properties of opiates are:
physical tolerance marked with a need to increase dosage to maintain the same effect and withdrawl symptoms when abruptly discontinued.
I believe an addict/alcoholic uses substances for psychological reasons.The pain may have been the contributing factor for starting them but once the addict finds that they do everything else for them too,it's off to the races.
I also believe a true addict had the propensity before they even picked up a mood altering chemical.In other words,I believe it's genetic.
I can go back in my own history now that I'm an adult and see that at early age I was a malcontent little dude.I had all the makings of an addict waiting to happen.When I discovered at 15 that marijuana,acid,alcohol took away all that fear and angst,it would have been great to have picked up a desire chip then and saved myself many years of misery.
I think everyone has to find their own personal truth with this.I know today that I don't put everyone in a black and white category.I have a girlfriend in South Dakota that I was in rehab with who is doing great.She drinks a little and smokes pot.She has never gone over the edge?I personally don't think she was ever an addict.
I think it comes down to how much time you think of altering your present state of mind.Are you always thinking of how you can change some feeling your having?Depression,energy levels,trying to have a good time etc,?
I was constantly thinking of how I was going to get high.It got to be that I just couldn't wait till the weekend got here so I would start on Thursday,then it became Wednesday etc....
Self honesty is the key.
My understanding;
Physical addiction is a biological occurence with extended opiate use.It wouldn't matter who started using them.The intrinsic properties of opiates are:
physical tolerance marked with a need to increase dosage to maintain the same effect and withdrawl symptoms when abruptly discontinued.
I believe an addict/alcoholic uses substances for psychological reasons.The pain may have been the contributing factor for starting them but once the addict finds that they do everything else for them too,it's off to the races.
I also believe a true addict had the propensity before they even picked up a mood altering chemical.In other words,I believe it's genetic.
I can go back in my own history now that I'm an adult and see that at early age I was a malcontent little dude.I had all the makings of an addict waiting to happen.When I discovered at 15 that marijuana,acid,alcohol took away all that fear and angst,it would have been great to have picked up a desire chip then and saved myself many years of misery.
I think everyone has to find their own personal truth with this.I know today that I don't put everyone in a black and white category.I have a girlfriend in South Dakota that I was in rehab with who is doing great.She drinks a little and smokes pot.She has never gone over the edge?I personally don't think she was ever an addict.
I think it comes down to how much time you think of altering your present state of mind.Are you always thinking of how you can change some feeling your having?Depression,energy levels,trying to have a good time etc,?
I was constantly thinking of how I was going to get high.It got to be that I just couldn't wait till the weekend got here so I would start on Thursday,then it became Wednesday etc....
Self honesty is the key.
Case in point..I am the perfect example of an addict who is now "dependent".....I do NOT take as much as precibed..I take less...however due to the tolerance factor...my dose does not help as well as before. But I do NOT cheat, lie, or steal because of it...as a matter of fact I am weaning myself off because what is the point if it doesn't work as well...I may as well get off the merry-go-round. Not everyone who builds a tolerance will revert back or develop addictive behavior...it is common..but having been down that road I decided it was time to get out...it isn;t easy...I can only taper 10 mgs at a time...maybe per month. But I am still on the way down. Sharonn
