Physical Dependence/Addiction

[YankeeCandle224]

This is a post I wrote a few days ago re: "I'm a pain pill junkie, or so they say" on this forum. I am an RN and know the difference as well between dependence/tolerance,and addiction and wanted to post my reply here to back your post up. I agree with you and wish more people understood this, mainly the docs.

There are MANY pain docs who have no right to call themselves pain management doctors. I've been to so many and they want to do this epidural or give me Ultram which makes me violently ill, or had one tell me to go buy a bullet and bite on it. To those doctors I say kiss my ..........Finally I am on top of my pain for the most part, after looking long and hard for doctors to listen to me and to look at me like a person, not a hysterical woman. Anyway, heres the post I posted the other day.


Veteran User
Member # 6214

posted 01-11-2004 03:37 PM
--------------------------------------------------------------------------------
First let me say, there is a HUGE difference between DEPENDENCE and ADDICTION. No matter what you take, asprin, advil, or percocet, your body will build up a tolerance to it over a certain amount of time. This is normal human physiology.

My parents think I am a junkie, my mom actually called me one on the phone, and at that point I wasnt even taking pain pills for the fibro.

I read above that if a person is in chronic pain, and takes their meds as rx'd , doesnt frequent the street corners for a fix, alter the drug by crushing or snorting it, you are NOT addicted, but you probably ARE dependent.

Good doctors know the difference and know that every so often meds for pain must be tweaked and fine tuned for the person and that everyone is different.

I take enough meds that a normal person would be flat out cold, or dead, if they took what I do in a single dose, but because I've been taking the meds for about 2 1/2 years, I am tolerant/dependent, and my body has adjusted to the dose.

Right now, with this suspected IC, I have had to increase the amount of hydrocodone that I take for breakthru fibro pain. Without it I am a withering, flopping dying fish on my couch. I am in severe pain without the extra help.

I know that my uro and my pain management doc will get together on this and 'tweak' the hydrocodone, so that I have enough on hand for painful episodes like I am going through now with my bladder and urethra.

This IS a never ending debate, but I guarantee you that 99% of the people that do the research with real people in real clinical trials will tell you the same thing I just did.

It's your body, your choice, no business of anyone's but you and your doc's and whoever you choose to tell.

If a family member doesnt like it, tough. I've had to totally stop talking to my parents, and while it hurts, and I miss them terribly, they are toxic people in my life, and judge me when they do not even know 1/3 of the story, nor do they care to know.

Please, please, dont let your family upset you, or anyone else about your use of pain meds.

It's none of their business!!!!!!!!

Hugs, Sandy

[Pain_Man]

In re: Julie Smith's post

Julie, do I understand correctly that you are cutting Duragesic patches into pieces?

I hope we're not talking about the same thing here. I hope you're on a morphine patch or something.

Fentanyl, the drug in the Duragesic patch, is THOUSANDS of times stronger than heroin. That's why it's dosed in millionths of a gram. The greek letter (Mu) you see on the package stands for millionths of a gram.

To cut the patch up or damage it is to risk destroying the thin membrance that regulates the flow of drug from the patch to your skin.

You also risk releasing a life-threatening dose into your body. Especially if you've already got large amounts of CNS depressants in your system already.

CUTTING UP DURAGESIC PATCHES CAN KILL YOU.

Like all narcotics it acts directly on your respiratory (breathing) center in your brain. Releasing a massive amount (such as the 10mg in the 100 microgram patch that I take) could easily end you up in the morgue.

If you're really doing this, STOP!!!! You're risking your life.

Not only that, but if you have children or pets (especially birds who are very susceptible to all types of drugs; my old man accidently killed a parrot with vodka 40 years ago--but that's another story) this makes what you may be doing even MORE dangerous.

I have a four year old girl and a pet rat. When I change patches, I always wash my hands before I touch anything or anyone else.

Someone cutting up the patches, is increasing the chances they will get a large dose on their hands and, if they aren't careful, could OD themselves, or someone, something else.

I just CANNOT emphasize how incredibly dangerous this practice could be. It would be like leaving a loaded pistol and a bottle of bourbon on the table with kids in the room and then heading for the grocery store.

Anyone doing this is just asking for tragedy.

***********************

Usual disclaimer: I am not a doctor or a pharmacist. Nothing I write is intended as medical advice; nor should it be taken as a substitute for qualified advice. I am only writing from my personal experiences in the hopes that they can help others.

You should ALWAYS consult your docs before changing anything about your treatment regimen or taking any new drugs--including over the counter ones.

[Pain_Man]

Yankee Candle...

Great post. Always glad to have professional back up. Especially from an RN. You guys actually do the work; doctors just kind of glide in and out and send bills.

I exaggerate. But only a little.

Not that long ago I would have been shocked at what some of the doctors told you.

Not anymore.

I've had some terrible docs.

One actually threatened to write to Social Security a phony letter stating that I was fine to get my claim denied.

Isn't that just completely amazing?

Another one, my first, the above guy was my second, told me that unless I had an expensive diagnostic procedure for my back (I have sciatica) he would cut me off completely from my pain meds. (What really happened, was they cut his reimbursement for my five minute visits from 50 bucks to $12 and I feel he just wanted to get rid of me as a patient because I wasn't helping him make his Lexus payments; I've heard he's gone back to doing mostly anathesiology because it's more profitable.)

I wasted zero time and got another pain doc who turned out to be a bigger jerk than the first guy.

Finally, I am with my current doctor who is an Osteopath. He's also a Chinese immigrant from Taiwan--so he's a lot more flexible than many MDs.

Unlike the other docs, he seems to actually CARE about his patients. He also does GP work, so my wife has started seeing him as well for chronic sinus issues.

Doctors and insurance companies: Grrrr! Sometimes, I don't know who's worse!

[Pain_Man]

As for the post quoted by our Candle (whose flame I hope lasts many, many, many more nights; in contrast to Edna St. Vincent Millay)...

I feel bad for Veteran User. Some people just aren't going to understand. "You're taking Percocet! You're a junkie!"

And this attitude is fed by media hype and government propaganda.

To the poster who was worried about being "political" on the "War" on Drugs, don't be.

Opposition to the war on drugs is bipartisan. I'm a staunchly conservative Republican who has to turn Left to see Ronald Reagan. William Buckley, the founder of our movement, has publicly advocated ending prohibition for more than a decade.

Many Liberals are also coming to a similar conclusion.

The War on Drugs helps only cops, drug dealers and politicians and corrupts the first and the last.

But it also hurts pain patients who get lumped into the category of "drug addict" when they are nothing of the sort.

I have also noticed the fashion among celebrities (most recently spouted by a certain singer with some serious issues and white glove) to blame their "injuries" for their addictions.

There's about zero evidence to support this. Unless you have Elvis doctor (which you can't since he lost his license years ago), you've little chance of your doctor getting you addicted.

Still, the media waits with breathless anticipation for the next drug scare. They whip up the hysteria machine not realizing (or, in many cases, caring) the stress they put on pain patients who now have to worry,

"Will they take my medicine away? Will they make it harder to get?"

Unfortunately, Veteran User, your pain pills aren't just your business. The Feds have records of every controlled substance (and all opiods are Controlled or Scheduled drugs under the "Controlled Substances Act of 1970"); your state police, or, if it exists, your state DEA, has records of every prescription.

There is no more privacy. If you truly new the number of people who can see your medical records, they could fill a small stadium.

But you are right, dead on, about one thing: keep negative people out of your life. It's hard enough not to be dragged down yourself; you don't need help with it.

God bless you all.


***********************

Usual disclaimer: I am not a doctor or a

pharmacist. Nothing I write is intended

as medical advice; nor should it be taken

as a substitute for qualified advice. I

am only writing from my personal

experiences in the hopes that they can

help others.

You should ALWAYS consult your docs

before changing anything about your

treatment regimen or taking any new

drugs--including over the counter ones.

[marcy]

Thanks for answering Pisces 228. I was diagnosed 6 years ago and I'm waiting to have InterStim done. I did make a call this am to a pain clinc and am waiting for them to call me back. My urologist has been helpful but I get the feeling he feels uncomfortable writing more than 30 pills a months. I do understand his concern, but I'm more worried about me. I'm sorry for your husband's pain. My husband can certainly relate to what you are going thru. Like you, my husband is very supportive and loving toward me an my addicition. I don't know how I would handle all this pain if it wasn't for him. You sound like the same type of person. IC patient's appreciate all the understanding and care we get. So thank you for taking the time to write me back. Now all I'm waiting for is a return call. I hope you and your husband, and all IC people have a wonderful day, or at least, a better day.
M in Georgia hi

[marcy]

Hi Pain Man and Mrs. Pain Man. I just hung up the phone with a pain clinic. I have an app't next Monday afternoon. Now all I have to hope is that Humana gets my referral pronto. They are usually so slow. But I'm hoping. Thanks for all your help. Have a great day.
M in Georgia kissing

[Julie Smith]

I have a 3 month check up appt. w/ my uro. next week. He had only given me enough pain meds, valium and maxidon for 2 months and told me to see a pain dr. Well, I dragged my feet because I am nervous about seeing another dr., will he understand ic and will his treatment work for me.
Yesterday I called my uro. to get a refill on the above pain meds. and nurse called me back and said dr. told you to see a pain dr. so he won't refill those meds. Appt. w/ pain dr. is next week, I had made the appt. but this pain dr. has a long waiting list. 3month check up w/ uro. is also next week.

You know, the last thing I want is more drs. I wish I could just wake up one morning and be healthy and thin!!!!!!!!!!!!!!!!

To make matters worse, my back went out on me yesterday. This happens every once in a while and gradually goes away. If any of you have had your back go out you know what I'm talking about. Anything can cause it, this time I bent over just a little bit to put my wet hair in a towel after stepping out of the shower.

Thank you all for listening!
Julie banghead banghead banghead banghead

[Julie Smith]

ps....I am not addicted to any pills. I have always been aware that could happen so have been very careful. Every appt. w/ uro we discussed because he doesn't want me to either. I was just surprised he wouldn't refill.

Say a little prayer the pain dr. helps.
Julie cussing banghead

[YankeeCandle224]

Julie,

I can't believe your doctor. He of all people should understand the amount of pain you are in.

I understand totally the feeling of finding yet another doctor, telling the whole story of your illness to them, and wondering what they will think, or do.

I wrote somewhere that the hippocratic oath says "FIRST, do no harm", by not treating your pain he is causing you harm. You may call and mention that to his nurse. You have to be bold, and stand up and say "LOOK, I am a human being here, THIS is my problem trying to find a pain mgmt doc, and I need YOUR help til I see the new doctor.

I have had so many doctors try and back me into a corner. I let them to begin with because I was so sick from the fibro/cfs, and my plethora of medical problems that I was too afraid to stand up for myself and much too sick to fight it out.

I wish you the very best, but HATE to hear that anyone, ANYONE is in unnecessary pain. It ****** me off frankly.

I got very lucky with my pain doc, he was referred to me by my orthopedist, who was checking my back to see if I needed surgery. He knew I was in a great deal of pain that was not being attended to and told me of this pain mgmt doc. I was afraid, just like you, one more doctor, sigh!

But, it turned out great, and though it may take time to find the right combo of doctors, it is well worth the fight. It's your body, you deserve to be treated like a human, and the medical community often treats us worse than animals. I LOVE animals and have a mini zoo, but if they are in pain, they get meds, right on the spot. It's unbelievable.

If you ever need to talk to learn how to talk to a new doctor or to find another if necessary, pm me, and I'd be glad to help.

I said somewhere else that I was a self proclaimed doctor finder lol and can really help you to help yourself.

Take care, know you are not alone as I have been where you are many times.

Hugs, Sandy

[Pisces228]

Quick reply, as I'm at work.

Good for you, Marcy! I'm so glad you're taking charge of your pain. Although I AM concerned that you still refer to having an "addition." Remember, it's not addiction. At worst you may become physically DEPENDENT, which is a physiological thing. But NOT addicted. Addiction is a mental state of mind more than anything. "Dependent" is not a bad thing if pain medication HELPS you to live a more normal, FULFILLING life. My husband functions at a MUCH higher level on pain medication than off of it. It truly helps him and, in turn, helps US as a couple and a family. Remember: it's about LIVING WELL, not just EXISTING.

[Jeanne D.]

After reading all of you posts I wish you all had the same primary as I do. He is totally wonderful and supportive. He understands pain and the need for medication. He actually "yells" at me for not taking what I need to. Being an RN I certainly understand about addiction and this was one of my major concerns. My MD assures me I will not become addicted with the type of pain I am experiencing, but will benefit from these meds. He says "that's what they are there for, take them when you need to." I have also seen a pain specialist and he totally agreed with my primary.

Wishing all of you days as pain-free as possible. Take those meds when you need them!

Jeanne D.

[Pain_Man]

Excellent post Yankee Candle in response to Julie's doctor woes.

I completely agree with you. A lot of doctors think getting thru Med School endows them with godhood.

Wrong!

We are so on the same page. You have to demand--albeit with however much diplomacy the situation requires, you can't be a boor or a loud mouth--what you need. First prove that you need it; then find the doc who "get's it." It can be a tough row--I went thru two pain docs before I finally found my ortho! He's also a practicioner of Chinese medicine and alternative medicines as well. (For those of you in Rio Linda, this means he's Chinese as well.)

They true, righteous docs are out there; it just takes some looking, not unlike the search for a spouse, to find them: sometimes it's luck, sometimes it's knowing the right people, sometimes it's happy accident.

By whatever method, you can get the care you need--if you've got the insurance/money.

Take care!

[MissMary]

Hi Guys hi I have an appointment on thurs with a pain management doctor. I am excited at the prospect of a better life and I'm also nervous. What if this doctor doesn't understand ic and pain it causes ? So, I'm a hoping and a praying that relief truly is in sight !

[CharAnn74]

My uro thinks the exact say way pain man.....thank god.

:woohoo:


He manages all my pain meds, and as long as I do not get them anywhere else he will continue too, and I have never gone without since I have been with him.He is a lifesaver.My first uro would not give me anything at all, in fact told me my IC pain was from IBS?!?!?!

He also wrote some things about chronic pain and pain meds.Something along the lines of :That if someone is in chronic pain and does not get the medication they need to control the pain, they will appear to be a "junkie" to a doctor, as they are nervous, and desperate cause they do not have the meds to control their pain.

I know I had my reg doc thinking that at first, since my uro would not give me pain meds.She was on me about finding a pain clinic and what not, telling me no more pain meds from her.I was desperate, I was hurting.

Now that I have what I need, I always have more than what I take on a daily basis, and I never run out of the script before it is time.And I am alot more calmer, and happier knowing I have the pain meds.

[jeanniebug]

I was just sitting here today wondering if my taking hydrocodone was ok, if I am physically addicted. I was surfing the net and getting myself all worked up when I hopped back onto the IC website and saw these posts. My wonderful new urologist who I am eternally grateful to have found in my new location, (after going through about 8 unsympathetic robot urologists in Chicago) has agreed to prescribe me 15 hydrocodone tabs at a time (500 mg each) for my severe flare ups. Well due to a recent back injury for which I'm currently in physical therapy, I've been given more hydrocodone than usual. My urologist is aware of it all. I've been cutting the pill in half and taking 250 mg to 500 mg ONCE per day, whereas the prescription bottle says take 1-2 whole tablets every 6 hours. I've been on the 250 mg per day for about 2 months now, and I was all worried about it. I only take the half a pill around bedtime, it helps me sleep and takes the edge off the "rawness" I feel in my bladder at the end of the day. Sometimes I take it in the middle of the day it just depends. I am not working right now due to pain problems, and I am relieved to see that I am probably not addicted..maybe dependent as you all have said..but I don't think I'm addicted. I don't feel the need to "up" the dose and do skip a day here and there, and I'm not in it for the "high". My urologist told me flat out that he did not think I should just sit there and suffer, he believes in this IC pain and feels pain meds should be used for chronic pain. I even tried to argue with him I have an addictive personality (i.e. cigarettes, drinking alcohol pre-IC diagnosis of course) and probably shouldn't take the hydrocodone. He said most people who take pain meds for chronic pain don't get addicted. Even after he said all that, I decided to worry about it out of the blue today. So thank you pain man and everyone else who posted. Sometimes I have to remind myself that I didn't ask for this IC, and quality of life on a daily basis is something I deserve.