Re: addiction/dependency

[Guest guest]

Hi Rick,

I'm new here and certainly don't want to get in the middle of

anything, but a psychiatrist I saw a few years ago defined the

difference to me. He said that if you are addicted to a drug, you need

to increase the dose to get the same benefit.

Dependency was slightly different. Your need did not increase over

time. However, if you stopped taking it cold turkey, you would still

go through withdrawal symptoms.

When I had my tethered cord surgery in 1992, I had been taking Xanax

for sleep for years. In the hospital they recorded this drug " as

needed for sleep " and did not give it to me as a matter of course. I

was so zoned on morphine I didn't realize it and after several days I

hardly slept and was really jumpy. The nurse was shocked when she

discovered the mistake. However, I am considered " dependent " because I

do not need a higher dose for the same benefit.

Hope this helps.

Genie

>

> Please explain the difference between addiction and dependency.

[Guest guest]

Genie -

Thank you for that insight into the distinction between addiction and

dependence.

-- Heidi

[Guest guest]

I agree with Kathy about her analysis of pain medications.

I speak from recent experience, as I had to withdraw from oxycontin

after my TCS surgery. I'd been taking it on a scheduled basis, not

as-needed. It was effective for my pain, but I had no idea that I'd

become dependent, as I'd never had a high. So, when my need for such

heavy pain relief diminished, I was completely unaware. However,

the dose I was taking was so high that it was depressing my nervous system

and preventing my recuperation, as I learned after a trip to the emergency

room. When I realized this, I told my physiatrist that I wanted off

it and didn't want to taper off, but go semi-cold turkey, in that instead

of trying to go completely med-free, I dropped down to hydrocodone (vicodin)

for pain relief. It was a nightmarish week of withdrawal, and I had

to have valium to help me get through. However, I never had any emotional

draw to the drug since I'd never had a high from it, so once the physical

symptoms were over, it was over for me.

-- Heidi

Moulton wrote:

> Hi Kathy,

>

> Please explain the difference between addiction and dependency.

My brother

> had chronic bursis (sp?) knee infection with several surgerys.

He had

> severe pain and became 'addicted' to his pain medicine, I dont

remember

the

> name, it was a narcotic and his doctor gave him as much as he

wanted when

> he wanted it. He had to go to a 30 day drug treatment center

to get off

> it. Was he addicted or dependant?

Unfortunately, your brother (as well as a good friend of mine) had

a

terrible doctor! (Who should have paid for the detox he went through.)

IMHO...Addicted.

A friend of mine in Palo Alto CA is on

> morphine via pump for chronic upper back/neck pain. She calls

herself

> 'addicted', if they lower the dose, she has withdrawal symptoms.

Is this

> addiction or dependency?

IMHO...dependent and confused. If I don't have my daily dose

of synthroid

(a synthetic thyroid hormone) I also will go through withdrawals.

I am

"physically dependent" on it. My body is used to this in

its system and

will do strange things to me if I don't take it. However,

I could care less

if I don't take it and if I wasn't tapered off it, I'd go through

withdrawals and then never look back. I, personally beyond

having my

thyroid regulated get nothing out of taking it. I don't get

a euphoric

feeling, it doesn't help me sleep, nothing for my "mind."

If I'm tapered

off it however, my body will slowly (like you with baclofen) get

used to not

having it in my system and I will have no ill effects from not

taking it,

pyschologically or physically. (I will however become very

overweight and

have other problems from having no thyroid hormones in my body.)

If they suddenly stopped refilling your pump would you 'feel' any

different?

Does Baclofen either orally or intrathecally give you a high that

you like?

Nope, right? However, if they stopped the dosage suddenly,

you would more

than likely experience withdrawals including but not limited to

naseau,

vomitting, siezures, headaches, lethargy, etc. If they tapered

you off it

and you didn't need it anymore because you were magically cured

of the

condition that requires the drug, you could care less that you

didn't have

it anymore and would probably look forward to not taking it.

When I take my pain meds, which happen to be in the narcotic family,

I don't

get a "high" from them. I feel no different than before taking

them, except

my pain is helped. I started on a low dose and initially

was tired when I

took them. Once that side effect was gone, they upped my

dosage until the

side-effect was gone, then continued until I received adequate

pain relief.

Now, this is when it gets tricky with people...if they continued

to up my

dosage after I received adequate pain relief, I would eventually

feel some

euphoric effects from them. (This is why a Good pain clinic

will never try

to give you complete pain relief with narcotics...) If they

continued to

give this dosage to me and I continued to take it, then yes, I

would not

only be physically dependent on it, I would be addicted.

I would want that

high. The medicine now does more for me than just help my

pain.

For whatever reason people use to take more than needed (be it they

can't

handle life well, they got in too deep before realizing where they

were with

the meds, etc), they now feel a physical, brain dependent need

to take it.

When you exceed what the body needs, there is left over...that

left over

with narcotics will usually produce a high. Because I take

what is needed

and no more, I don't ever get that "high" because I was put on

them slowly

and never, ever take more than necessary. The amount I take

attacks pain

signals and is just enough to do that. More than that...well,

I walk around

stoned while it's in my system.

Let's say you took Baclofen orally (I use this drug because it's

a drug you

can relate to.) It does its job and takes care of your spasticity.

One

night you take too much by mistake and you notice it puts you to

sleep

really well...you're out like a light (and for argument sake, let's

also say

you have a sleeping problem so this is really great for you.)

The next night you do the same and the next and you eventually "up"

the dose

because the sensation you get is something you like. Now,

if you continue,

you will probably be addicted at some point. Not only do

you need it to

control your spasticity (physical dependence because of the nature

of the

drug), but you're addicted...your brain needs that drug....you

have

essentially rewired your brain at some point and you will need

help coming

off it beyond a regular taper. You'll need to learn to sleep

on your own

without pills, you'll need to find a way to get through the day

without the

high (I don't really think Baclofen can give you a high though...although

I

don't know either.)

Addiction is when you are not only physically dependent on a drug,

but

physcologically also. I could quit smoking tomorrow if all

I had to do was

to go through three days of withdrawal and it was all over.

I've done the

three days many, many times...I truly do not physically need that

cigarette

anymore. But, talk to me on the phone and I NEED that cigarette,

give me a

meal and afterward, I will NEED that cigarette. That's the

addiction part

of it.

There are many, many drugs that every-day people take that are drugs

they

will become physically dependent on. Just as strongly as

someone taking

narcotics will be. High blood pressure meds are notorious

for producing

horrific side-effects when stopped suddenly, and again, thyroid

meds

too...there are so many regular old conditions out there that people

take

the medication for, but the medication is a physically dependent

drug.

There are some that aren't too.

I hope this makes sense...I am by no means an expert on this.

I know these

terms are used interchangably. However, one is something

your body is

dependent on and requires, but can handle being without if tapered

off...the

other is something that not only your body needs, but you need

as well and

even when your physical being no longer requires it, you still

do.

Kathy

>

> Rick

>

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