Author: SnapShawt

Posted: Mon Jul 01, 2013 2:47 pm

qhorsegal, thank you for taking the time to reply, and you certainly did not step on my toes. I opened that door talking about it myself. I have thought long and hard about the "dependence v. addiction" thing, and still am. And you bring something up that I see from both sides.

Yes, the behaviors you speak of are certainly signs of addiction, though obviously cannot alone be interpreted as such without other circumstances in the mix. Let’s take the scenario you speak of – immediate release from doctor. Would I personally have sought out the Oxy on the street? No, I wouldn’t. I can honestly say that I probably would have ended up in the emergency room in withdrawal explaining why. But that’s me. I would not think automatically though of another that WOULD do so as an addict. And I think that for the same reason that I was definitely very anxious about the Oxycodone. It was a medication I was receiving for a legitimate purpose that I had always taken as prescribed, never abused (though I admit to that one instance that I had to step back and take an inward look) – no different from any other person with receiving any other medication for any other condition. If they were on a type of medication which was suddenly removed, and they knew that such removal would send them into intense agony – you bet your bottom dollar they just might do whatever they could do to get it. Because they’re addicted? Maybe they are, maybe they’re not – but it is certainly not unreasonable to expect them to want to avoid the misery they know is coming without it. If the measure of addiction is the desire to avoid intense misery and agony and the willingness to do just about anything to do so, then there are a WHOLE slew of different types of addicts out there.

Again, yes, I do agree that is is ONE SIGN of addiction, but it must be taken into consideration with the whole picture. Do they have a history of abusing the medication – taking it not as prescribed or for the purpose intended? Do they have a history of "losing" their medication or having it "stolen"? Many other things to consider obviously. If however that person were only seeking the medication on the street after the immediate separation and no other factors or circumstances were present to indicate addictive behavior, then I would very likely see the person as someone who has been abandoned as a patient through no fault of his own (not someone who was "fired" for addictive behavior) and is desperately trying to avoid the consequence of it.

I am not contending that this is my case. I don’t know if it is, only because of that single instance that I’ve always remembered of reaching for the Oxycodone at a time of intense stress, though I did back off. And that’s my problem. If I had been abusing it – knowingly taking it not as prescribed, losing it or it being stolen, etc., then I would certainly be lying to myself not admitting to addiction. But those factors do not match my experience. Basically, I have two KNOWN things that are "matches" I suppose:

1) There was an instance in which I reached for it when I did not need it but instead as an emotional response.
2) I have become stressed and anxious when suddenly no longer having my doctor and finding a new one.

I may very well have been receiving some unconsciously realized benefit from it other than pain relief, I just don’t know. That instance I refer to may have been more telling than I thought it was after some consideration. Again, I don’t know. I am however trying to be open with myself (and here with you) in admitting that the possibility exists and deserves more serious contemplation. I absolutely do make a clear distinction between addiction and dependence. There are may who must have this medication for legitimate treatment. I have been one of them. Dependence and toleration cannot be avoided when it is used long term. When suddenly removed from it, such patients are then facing not only a return of the pain for which they initially sought treatment but also horrendous withdrawals from the medication that has been used to treat it.

Now, let’s add a THIRD factor to the two I posted above:

3) The pain has returned and is not controlled as well, but it IS tolerable. There are times – once or twice a day – that everything locks up badly, the pain is through the roof and I’m eating Excedrin. Usually after an hour of that misery it does begin to subside. It is NOT, however, as constant as I remember it being initially when all this began.

So, THAT so far tells me that I probably could do without the pain medication and instead only needed it maybe once a day – the periods that it gets intense. And just like that instance I referred to earlier, this is an area of concern for me that I factoring into the equation. I see two possibilities here:

1 – I psychologically enhanced the pain by equating pain relief with pain medicine, regardless of the intensity.
2 – Hyperalgesia (instances in which taking pain medication over a long term can actually have the OPPOSITE effect in which it creates more "pain" so that you’ll take more of it – the brain’s way of making you give it more of what you’ve been giving it.

In any event, I MUST make some determination on this. If I am merely dependent as a result of tolerance and length or a medical issue such as hyperalgesia is present, that’s one thing. If however I have actually become addicted to the medication, then that is a horse of a different color. Each of those requires a different approach. Until I know which it is, I don’t know what approach to take.

In the end, the use of pain medication long-term to treat chronic pain develops problems for both dependents and addicts, and sometimes (perhaps often) that line is heavily blurred. It certainly is for me right now. But I really do appreciate the input of yourself and others – it helps in the process of trying to "unblur" it.