Re: Drug Dependence vs. Addiction

[Guest guest]

Hi Jen (and Jens hubby),

I really understand your frustration and also your husbands fears.

All of us have heard so many scary things about what can happen when

a person is on drugs, no matter why they are on them. Years ago I

read about a study done on narcotics and people with chronic pain.

Only 0.1% of the people in the study, became addicted. In fact, using

pure narcotics in general against chronic pain, gives much less side

effects than using non-narcotics as e.g. Tylenol, Aspirin and other

NSAIDS...

All people who are on narcotics, will experience that their body gets

dependent on it. This means that if you suddenly stop the medication,

you will experience _physical_ withdrawal symptoms, just like a

person who has an addiction e.g. to illegal drugs. You become

physically ill.

But, this is only a physical phenomenon. There is the huge difference

between us who need that kind of treatment for severe chronic pain,

and people who have an addiction.

First of all. Addiction has two components. Most importantly people

who are addicted to drugs, take them to get _high_, they experience

becoming " intoxicated " (e.g. euphoric, lethargic, apathic, stupor). In

addition to that, they also become physical dependent on the drug.

They just can't stop because of the physical side of it combined with

the psychological side of it (needing to become " intoxicated " /high,

feeling that they can't cope with being " sober " , fear of getting sick

/ having to treat the physical illness withdrawal symptoms cause).

The psychological side of not being able to face the reality sober,

is the strongest component in drug addiction.

A person with chronic pain uses the drug to take the pain away or to

reduce it to a level they can cope with. Most people with chronic

pain does not experience any intoxication whatsoever if they are on

the right dosage. Some do experience some at first when they start

the medication, but it normally goes away quite quickly. Many also

feeling tired because of the medication, again especially at first.

When you talk to people with chronic pain, they don't want to " feel

the medication in their head " , most experience such a side effect as

very uncomfortable. Such feelings is not why they take the drug.

This is a very important difference between a person who is

physically dependent on a narcotic pain medication and a person who

take the same drug to become high. In order to be addicted to a

narcotic, you need to have both components, both the physical and the

psychological side of it.

If a person with chronic pain for some reason no longer need the

drug, quitting is normally not a problem at all. The drug must not be

discontinued quickly though, but gradually so that the body can adapt

to not getting the drug.

A situation where a person with pain can risk becoming addicted, is

e.g. if a person has had a period of pain for some reason, e.g. after

an injury or a surgery. If the person then continues taking the

medication even if the pain is getting better, a risky situation has

occured. Then the reason for taking the medication has changed, the

person is no longer taking the pain medication to relieve pain only,

but because the medication is causing a feeling which the person

would like to still have even if the pain has subsided.

A few people with chronic pain does get problems with the medication.

I think most of these people have trouble coping with their health

problems. Many of us have met some who have that kind of problem, and

seen things... They may start fooling themselves, taking medication

even if they maybe don't need it that much that day, and also taking

too much of the medication in order to dull e.g. the psychological

pain of having EDS or any other chronic disease / disability.

According to the study (which I unfortunately do not have references

to), the risk of this happening, is minimal. I really do think it is

important to have a deep respect for these medications and the

possible negative effects they may have. As long as you have that,

and use the medication as directed by your doctor, you will most

likely be fine.

We always have to weigh the effects of the medication and the effects

of the disease itself on our life and function level, when starting

medication. I am not in doubt whatsoever that narcotic pain

medication can be of tremendous help for people with EDS, that it can

mean a huge difference in the quality of life for people. I know for

myself that getting proper pain relief, has meant a huge difference

in my life. I also think that the risk of developing problems is much

less when you are on depot pain medication. When you use that, you

need less medication and you have a steady release of the medication

in your blood stream, you are not in a situation where you have

medication that works for 3-4 hours, you are on a pain roller coaster

and how much pain relief you have varies a lot during the day. If

that is the case, you normally also need a lot more medication

because you are never able to really cut a vicious cycle... I

decided that I would never take too much of the medication though,

even if I have so much pain I would have done anything to make it

better. Some days are just like that, it spins out of control. But

most days are much better than they used to be, and that makes a huge

difference!!!

Maybe you can let your husband read this post? I hope it explains the

difference between addiction and physical dependence OK enough...

Take care!!!!

Aase Marit