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Old 12-11-2009, 12:54 AM   #1 (permalink)
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Opiate Dependency or Opiate Addiction?

I am relatively new to the site.... Actually very new to the site..... Very new to thinking I have a problem..... Then again, I still dont know if I have a problem?
My big question is, when does a person in chronic Pain that is dependent on opiate pain medication for day to day living have a problem?????? I guess I mean, whats the difference between opiate dependancy and opiate addiction? Is there a line? Is there a grey area? If a person was to finish there prescription early, does that make them an addict, or just a bad pain month? If they snorted/smoked there medication is that an addict??
I require the drug to relieve pain so I can go to work, function as a husband and a father, but I enjoy the feeling/high I get as well.... does this make me an addict?

ALRIGHT! how 'bout I start a thread!? lol.... what you guys think about this topic?!
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Old 12-11-2009, 01:11 AM   #2 (permalink)
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I can only speak for myself....

after 20 years of addiction and abuse, if I'm not taking my meds as directed - either in volume or delivery - and I'm taking them because I enjoy the high as much as, or more, as they bring pain relief...I'd consider myself in trouble.

How do you feel when you finish your meds early?
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Old 12-11-2009, 11:02 AM   #3 (permalink)
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I think if it starts to interfere with your day to day life then you have a problem. If you run out of meds early every now and then it's one thing but if you're running out early every month and either buying drugs off the street to get by or just toughing out the withdrawls until you get your refill then you're probably an addict. I would definitely say that snorting/smoking your medication is abuse -- do you really think you need to do that for pain control?

In the end only you know if you are an addict but in my experiences with friends and myself -- if you have to ask, you already know the answer.
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Old 12-11-2009, 03:18 PM   #4 (permalink)
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I too, look at addiction as including abuse.
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Old 12-11-2009, 04:09 PM   #5 (permalink)
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Quote:
Originally Posted by sandnuka View Post

If they snorted/smoked there medication is that an addict??
Not a grey area... red flag for sure!

Addicted, I don't know, but it's drug abuse. Are you an addict? Only you know that.... but you may want to look at your relationship to the painkillers... it's not normal.

Welcome, good thread.

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Old 12-11-2009, 05:11 PM   #6 (permalink)
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After my knee surgery, my doctor said that you can become physically dependent on narcotic pain meds after taking them as prescribed after just two weeks. Having to take them for true pain as prescribed is one thing....being totally obsessed (as I was), is quite a different story.
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Old 12-11-2009, 07:34 PM   #7 (permalink)
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I really really enjoyed reading the responses.... thanks for all the replies, very interesting responses. Just wanted to clarify... well I know I dont have too, but felt I needed to make it clear.....

1. I personally do run out of pain meds about 25% of the time 5+ days before my next refill. but as an excuse have just added sciatica leg pain to my list of problems.... and have yet increase my meds with my doc. I have got steriod/epideral injections recently, did not help much.

2. I have smoked/snorted my medication as a rec. thing more than a few times on the weekend... (because I cant drink with them) and kinda feel left out from the crowd at parties if I am sober, (taking my med as prescribed). I do not smoke/snort my med to increase the strength of the drug for pain... My script is typically strong enough to take make me comfortable.

3. the people closest to me, (wife, mother, daughter, work) all agree I am a better person on my medication.... now friends that know just how much I am prescribed say I have a big problem.... could be they dont understand tolerance.

I am going to share my prescribed med doses, and I would like an honest opinion on if you think I am opiate dependent, or an opiate addict/abuser. maybe if you think I am in the grey area. (I do enjoy the "high" I get.... I do not "nod".... I feel stronger, more awake, and healthier is the "high" Im talkin about)

Methadone 10mg 3x daily
Oxycodone 30mg 6x daily
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Old 12-11-2009, 07:56 PM   #8 (permalink)
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I do see red flags, as I said.

If you want to think that they're not as red, or they're mitigated by current circumstances, or whatever - that's your prerogative J.

I'm gonna leave this one to those with more experience than me, but I don't think you can determine addiction on dose alone.

D
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Old 12-11-2009, 08:13 PM   #9 (permalink)
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Personally, I don't think your doses are relevant to whether you have an issue with chemical dependency... how and why is what is important. You need to answer these questions with rigorous honesty. And my opinion (you have solicited it, I assume, given your post...) is that you are not being honest with yourself.

It is an important journey you are on. You are looking for answers, I hope you find them.

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Old 12-11-2009, 09:09 PM   #10 (permalink)
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I don't want to stomp all over what your pain doc is doing so this is purely my opinion and nothing more.

Quote:
Originally Posted by sandnuka View Post
Methadone 10mg 3x daily
Oxycodone 30mg 6x daily
This is ludicrous! 30mg of Methadone a day PLUS 180mg of Oxycodone (which, based on the 30mg dose I'm assuming is Oxycontin). That is an unbelievable amount of opioid pain meds! Not to mention that they are all long half-life synthetic opiates. WOW!

I'm like ... floored. Not by anything you're doing, but by what your doc is prescribing. Tolerance aside, one thing I don't see being addressed is the fact that chronic opiate use actually increases pain sensitivity (thus creating a cycle of pain and dose increase). I never prescribe long term opiates for any of my patients for exactly this reason. (And this creates quite a difficult situation in cats with chronic pain conditions as there are no real options for non-steroidal anti-inflammatory medications. But I'd rather deal with that than the more difficult issue of decreased pain tolerance in patients who can't talk to me about how they feel.)

Is your pain doctor doing anything else for you long-term? Non-steroidals? Gabapentin? Accupuncture? These are what I offer my patients and you deserve no less than they do. Not to mention that with those doses, even in an opioid tolerant patient, the fact that you run out kind of terrifies me.

I'm not an MD so there could be aspects about opiate use in human patients that I don't understand. But just looking at it purely pharmacologically, it freaked me out enough to make me post. (I'm not exactly active here. )

~eg

(true story: 10 years ago I had an anaphylactic reaction to ibuprofen. I like to do sports and so I had to deal with numerous non-serious injuries without the benefit of non-steroidals. About 3 years ago though I was in an accident and had major surgery on my leg where a portion of my quadraceps was removed. The PT was brutal and I had that phantom leg syndrome thing (it felt like my leg was in an uncomfortable position or being squeezed in a vice even though it wasn't). Non-steroidals would have been best, but I couldn't use them. I was on oxycontin for 5 months and I couldn't stand it. I hated the way I felt and I hated that I went into withdrawal when I didn't take the pills. I was so uncomfortable that I opted to spend a week at home miserable rather than keep it up. My leg hurt all the time for a few months after but it was better than the drugs. I kept up with the PT and accupressure. And slowly ... it stopped hurting. 2 years ago I was in a wheelchair. Today I spent 10 hours on my feet (back to back surgeries with no time for a break). So I understand where you're at. But I also believe that if I'd kept up on the opiates I'd still be in pain.)
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Old 12-12-2009, 09:08 AM   #11 (permalink)
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You can't really tell if someone is an addict just by looking at their doses. Even taking meds as prescribed you will build up a tolerance over time. There are non-addicts who take more than you and addicts who take less.
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Old 12-12-2009, 09:18 AM   #12 (permalink)
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Wink

Once In a Group there was a woman with a similar question and my response to her that made a light go off in her mind and made her say OHHHHHHH was : Theres a point when you stop taking the medicine to dull the actual body pain that you have and you start taking the medicine because it makes your HEAD feel better inside..... know what I mean.. hope this helps ... :-)
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Old 12-12-2009, 09:56 AM   #13 (permalink)
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This might help answer your question, am I opiate dependent, or an opiate addict/abuser.

http://www.na.org/?ID=litfiles/us_english/IP/EN3107.pdf
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Old 12-12-2009, 10:12 AM   #14 (permalink)
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I have always heard that people who are not addicted never wonder if they are.
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Old 12-13-2009, 09:20 PM   #15 (permalink)
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Thank you all again for all your replies.... I do have an appointment with my doc tomorrow..... I was honestly looking for something to just grab me, honestly I didnt find it in your responses.... again, I know I have to be the one that throws up the flag... and I just cant justify it yet.... I will go over some things with my doc tomorrow and see what he thinks.
I would like to respond to one of the posts though.... kittydr; lol, It was probably just 3 years ago when I first heard of someone taking high doses of opiate meds, and I.... Like you kinda freaked out! Honestly being on pain meds for so long I can take dbl that dose and really not get the same mental stimulation that I got off of two 5mg vicaden... its amazing how much tolerance you can build to these drugs....
My doctor actually had just sent me to get injections, the anesti, had allot of trouble getting me conciuos sedatited, and eventually gave up... lol.... also ive been seeing a massage therapist for spasms.... shared a floor with a acupuncturist at my health club many years ago, and really didnt get much relief from any of them.... My doctore and I goal is not to stay on these meds forever, but just enough until hopefully the inflammation in the bulges decrease enough over time that they dont push on the nerve... or if we wait too long, eventually surgery on the bulge... but this I heard there is a 30% chance of the problem getting even worse because of scare tissue build... and I, being only 28 yrs old, dont really want to take that kinda risk yet, especially since the meds do there job most of the time.
Thank you again everyone who responded... Honestly at the begining of my detox if it wasnt for this sight I would have been allot more uncomfortable... I see how this place can help allot of people in bad places... god willing I dont end up there.
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Old 12-13-2009, 10:12 PM   #16 (permalink)
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Please do speak with your Doctor, SN and do it honestly and openly - pain med issues need to be addressed as soon as possible - they invariably get worse, never better.

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Old 12-14-2009, 08:51 AM   #17 (permalink)
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One thing I know for sure is that if you stopped taking that amount cold-turkey, you'd almost certainly go through some incredibly bad withdrawals. Have you ever tried it? I'm not suggesting you do, but if you had ... lemme tell you, they'd suck. So, presuming that you get bad w/d's when you stop taking them, that would mean you are at least physically dependent on them. Which, taking that amount, is basically a mathematical certainty.

If you want my humble opinion, yes, you are also showing signs of being an addict. You seem like a smart person, so I don't think I really need to point out what they are, cause you already know.

Whether or not these drugs will eventually start to really wreck your life or not is probably going to come down to whether or not you get off of them before you either a) get cut off by the doctor or insurance company, or b) happen to stumble across someone out there in the world that you can buy them from.

IOW, how *much* of a problem these drugs can be is often not apparent when one has a (basically) free and ample supply from a doctor. If you suddenly lose that (and BELIEVE ME it can happen), you can find yourself in a whole heap of trouble, esp. on the kind of dose you're talking about.

As others have said, only you can figure out whether or not you're an 'addict', but no matter what, it's very possible that you could end up with a huge mess on your hands. The road you're on here could lead to consequences that you aren't going to be happy to find yourself in.

Good luck, and keep posting
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Old 12-14-2009, 09:44 AM   #18 (permalink)
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There is absolutely nothing wrong with needing opiates to treat pain. If you have chronic pain and are need opiates to deal with it, you are no less of a person for it. Most folks who run into problems are either self-medicating or ashamed of actions they are hiding from their docs. If you feel you are in trouble, your doc can be your best friend. An honest evaluation of your situation and a willingness to do what it takes are all that are needed to get started.
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Old 12-14-2009, 06:03 PM   #19 (permalink)
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My friend,
I have 5 herniated disks and sciatic pain everyday. It comes in bouts of 2 to 3 months at a time. But if you're taking pain meds because, how did you put it, "It makes you a better person, isn't that what your family said? I'd want to check myself out. Insideous is what this disease is called, with good reason. Buena fortuna
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Old 12-15-2009, 01:27 AM   #20 (permalink)
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Update! So I went to the doc, Was very open and honest with him.... told him I have been running out of my meds about 25% of the time i had been on this dose... Told him, I had on a occassion crushed my meds and snorted them, not more than 5 times in the past three years, on the weekend at a few social gatherings.... (that is the honest truth, well left out the one time I tried smoking it).... Also told him about how intense my withdrawls were when I had run out...his response
"Joe, you know That what you have done, even a few times is completly irresponsible, and abusing your medication.... Running out of a IR (instant release med) is not uncommon at all, this is why I have recommeded you to go to a pain management doc to consult about alternative ER (Extended release) meds.... I do not prescribe these meds do to there street value, and the bad name they have (assuming he meant oxycotin). If you decide to go this route I would suggest seeing him for your pain meds. and Joe, I have noticed a huge change in you over the past few years.... you are much more upbeat, not as depressed, your blood pressure has dropped, your pain level has dropped tramedously and from what youve told me your life has improved so much. As long as you will never abuse you medication again, I am willing to keep prescribing them. You know, Our goal is to eventually have you off them completly, so we start today... I am reducing your medication by 1x30mg oxycodone, and 2x10mg methadone daily. I understand you have recently run out, but I suggest having someone hold your meds for you, and giving to you at you scheduled time if you do not have the will power to do this yourself."
SOooooooo...... I am noticing..... everyone who is an addict, has told me I am an addict and need to get off my meds and seek help immediatly........ everyone who is not an addict has been supportive of me, and has told me how great I have been doing.... including my work!! My wife, and my daughter!! these are honestly the people I should be getting advice from. I suppose this post kinda made me realize, if I want to be told I am an addict, ask an addict, they will tell me I am going to die, and my life is spinning out of control...... I can understand why though..... If I had a addiction, if my life was ruined from my addiction, I would do everything in my power to not let that happen to anyone else..... unfortunetly, this advice, for my situation would not help my life..... So once again.... Thank you so much for your responses, your thoughts, and showing me how much you care! I really really really appreciate it.....
freddie4621; if a drug/medication makes your life better/you a better person, you should stop taking it? because it is insidious? sooooo.... throw out the anti-depressants? The tylenol? heck anti-biotics stop my chronic sinus infections almost instantly, and make me feel wonderful the next few days.... should I stop those as well???? I believe all drugs have a purpose. They were created for a reason, to make people better, to make people not suffer, and some people cant take the narc meds due to there lack of self control.... but these medications themself make life better for people who can control themself.... So I strongly disagree with you statement. unless I completly read it wrong????
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