Agoraphobia Support Group

There has been a lot of talk lately about Medications.

I think that it is a personal choice and there is not a "right" or "wrong" choice. It is up to each individual what they want to do and also it is important to talk to your Doctor about your feelings and or concerns and fears or pros and cons. Everyone is different when it comes to Meds. What might work for 1 person may or may not work for someone else. If taking a Medication can give you back some quality of life then I think that is something that each person should think about and do what is best for themselves. I think that this is a great article about addiction vs. dependence and I hope that this is helpful to everyone.

Addiction vs. Dependence on Pain Medications

Pain expert Dr. Scott Fishman answers questions about pain medication:

Q: What is the difference between being addicted and being dependent?

A: Fear of addiction has prevented many physicians from prescribing needed pain relief and many patients from controlling their pain and reclaiming their lives.

Pain doctors have known for years that taking opioids over long periods of time for medical reasons does not have to lead to addiction. More than a decade ago, neurologist Russell Portenoy, who was most recently President of the American Pain Society, reviewed studies of almost 25,000 cancer patients. Most of those patients had been on opioid therapy for many years. Of the whole group, very few showed any signs of drug abuse, drug craving, or drug-seeking behavior.

Every one of these cancer patients was dependent on their medication. However, their physical needs were worlds away from addiction. Addiction is a biological and psychological condition that compels a person to satisfy their need for a particular stimulus and to keep satisfying it, no matter what.

It is a compulsive behavior that demands more and more drugs, regardless of the consequences that lead to dysfunction. A person who is addicted to opioids has a disease that undermines optimal function and drives one to compulsively use a drug, despite the negative consequences.

The pain patient who is effectively treated with opioids finds life restored-even if he is dependent on them. With the pain muted by stable and steady controlled use of long-acting opioids, a patient can reclaim his life, go back to work, return to family life, and pursue favorite pastimes. Dependence is a physical state that occurs when the lack of a drug causes the body to have a reaction. Physical dependence is solely a physical state indicating that the body has grown so adapted to having the drug present that sudden removal of it will lead to negative consequences such as a withdrawal reaction. This can occur with almost any kind of drug.

A good example of dependence is a heavy coffee drinker's use of caffeine. If you are used to drinking several cups of coffee each day, you soon learn about physical dependence when you miss a day or two. This does not mean you are addicted to the caffeine; it only means your body is surprised not to see what it has come to expect.

In the case of opioids, a certain amount taken every day fills the glass, and no more may be needed or desired. If the medication is removed, the consequences are physical (sweating, running nose, diarrhea, racing heart, or nausea), not psychological.

As any diabetic will testify about insulin, or any heart patient will testify about blood pressure medication, dependence is not necessarily indicative of addiction or drug abuse. In fact, regular use of these medications may be essential for good health.

The difference between a patient with opioid addiction and a patient who is dependent on opioids for chronic pain is simple. The opioid-dependent patient with chronic pain has improved function with his use of the drugs and the patient with opioid addiction does not.

http://health.howstuffworks.com/diseases-conditions/pain/ medication/addiction-v-dependence-on-pain-medications.htm

06/24/12

As usual, a most compelling point, one fascinating to those--like myself--take opiate medications that barely keep limb and sinew together.

I should--perhaps--be more comcerned about addictioon, or habituation; but since without the dread 'opiate', I could not function at all, I recenly told my pain doc, that 1) I do not medicate to prven 'break through' pain. If I can bear it, I will do so without running to my pill bottles; and 2) I d not use them recreationally, nor do I share them, or sell them, however ( and this is, I think important; 3) If, for example, I arise to pain that quickly increases until I can only it there, mutering bits of prayer, while rocking back and forth, crying in utter pain, should I then take a Dilaudid and a Morphone together, and, in 40 minutes am seating in agony, I AM going to double up my dose, as I cannot see the purpose of even having medications to relieve pain, if the pain--itself--cannot be remedied with only only dose, I will not sit there, and see the bottles, and refuse to ramp up my use of them.

Is this addicition ? Or a situational response for some relief. Is it habituation ? I cannot tell you; only that so-far, I take them to be able to have some vestige of normal, human life.

It would seem that the majority of the opiate's effects go straight to combat the pain; there is NONE left over to 'get high' from.

So, dear 'angelonearth', for me, the Jury is still out.

I would like--however, to wish for you and yours a very pleasant Sunday ! Please do take care.

'Zahc'

Thank you Zahc

I think that if a Medication can give someone a better quality of life then there is nothing wrong with that and it is a personal choice.

A person that is a Diabetic needs their Insulin or a Pill to function and have a better quality of life and most often without they would not have a life at all.

A person that has High Blood Pressure takes Meds for that and people take Thyroid Meds each day for the rest of their lives.

I believe that these are examples of Dependence and NOT Addiction.

Just wanted to share because I feel that there is such a negative stigma attached to taking Meds and really it is a personal choice and there is no right or wrong and it is choice that is to be made with the person and their Doctor.

This is a really good point. A lot of people think if you're on benzos and can't go without them that you're addicted, but this is just the automatic physical reaction your body has when you're on that type of medication on a regular basis. Once your body gets used to benzodiazepines you can't just take them away, you need to taper down slowly. I hate the fact that even doctors sometimes use the term addiction when referring to patients on benzos instead of dependence.

I have found what Zahc said about pain meds to be true of benzos for me. I don't get any "high" feeling from benzos because I have so much anxiety. They must cause some sort of high feeling to someone without any symptoms though, considering how much people are willing to pay to use them recreationally. I also don't think twice about taking an extra dose if needed, especially since I often go without them when my symptoms are not as bad.

Kevin,

The article that I posted applies to Benzos too.

People are dependent on many things not just Meds.

People that drink coffee every single morning that is a dependence.

I think that if something can give someone a better quality of life whether it is a Pain Medication or Benzos or whatever it is then that is a personal choice.

People are so quick to think that someone is "addicted" to something instead of realizing that without the Medication there is no quality of life.

Also when a Benzo and or a Pain Medication is used properly there is no 'HIGH" It is needed to treat the condition.

Post edited by: angelonearth, at: 06/24/2012 03:46 PM

Thanks for posting this Angel It's a great article. So many people need different meds to just function through the day. Medications for anxiety issues are no different than meds needed for any other illness. If you make the choice to use meds and it lets you get your life back then I say WHY NOT? I fought using any type of meds for years because of a fear of bad side effects from past experience. But it got to a point where I decided what the heck... I am miserable anyway, so why not try a benzo and see if it helps. The side effects seemed way less scary at the time than the way I was feeling daily anyway. It's my choice to only take it as needed for severe panic. But I personally am not worried about becoming dependent on it. If I would need it for the rest of my life I'm good with that. I am dependent on synthetic thyroid replacement med for the rest of my life to assure everything functions the way it should... so why not an anxiety med???

I'm super sensitive to meds and only take small amounts of the ativan at a time... 1/2 is usally the most I will take if that. Before my surgery I took the whole thing and didn't get any type of high (darn it, lol) it just evened out and took away the anxiety. In my teenage years when I had zero anxiety I used to sneak my moms valium for a buzz lol... But like Kevin said, when you have anxiety you don't get high... just sort of levels it all out

Thanks Conn! I am glad that it is helpful!