addiction/dependency

[Guest guest]

> 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

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> Rick

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