MySecretLove

Can someone tell me what the difference is? Is there a difference? Thank YOU.

dreamscape

addicted has more drug seeking behaviours involved, where dependant may be more "innocent" ---- such as a person who is on a prescribed addictive med for 2 long and doesnt abuse it, but who will have withdrawls if the med is stopped.

MySecretLove

Thank you.

oxyious

I'm both. I have chronic pain that by any Doctor is considered "Severe", but when the pills stopped working as much or I was craving the "feel good" that came along with pain killing properties or I started taking more to become emotionally numb as well as physically numb, or when I was seeking out alternative ways to get more pills... That is when I crossed over from Dependent to Addict.

I've been pretty much bed-bound/couch-bound since I've been clean, which really worries me because when I go about life upright again--the "wish I would just die already" type pain will return. I'm working with my Doctors to figure something out. I do get up and walk around throughout the day, but I do spend a ridiculous amount laying down with my 2 heating pads, laptop, bottle of OTC... In short, I won't go back to OX, but these Doctors better figure something out for me because I can live a normal life, but when I start my new job in August, I can't go lay down when I hurt.

So, short answer, in my opinion:

Dependent = Needing it to function due to severe pain

Addict = Doing ANYTHING but taking it exactly as prescribed. (including the delivery method, the amount and trying to obtain more than you are RXed.)

oxyious

I didn't want to start a new thread on the topic, but it sort of fits here. If you find yourself also addicted to either the method of delivery (chew, drink, sniff, bang, stuff) or the "process" involved in obtaining your DOC, you are definately an addict.

I managed to get about 3 hours of sleep tonight but I had a dream about using. OMG, those suck... and I'm one of the unfortunate that remember most of their dreams. (vividly). I used to say dreaming about it was great because you got to use in "fantasy/dream land" and stay clean in real life, but after you've sobered up, it's NOT cool to have those dreams. They make me cranky, irritated and leave me craving until I can throw myself in to conversations on the forum, see my therapist or journal the thoughts away. I use journaling as one of my coping mechanisms and it really helps me. I may not see anything special while I'm writing, but I'll look back and it' like a hand reaches out of my diary and slaps me in the face and I realize something new about myself and my triggers. sorry, /end rant. Its going to be a long/rough day..... I can tell already.

NVRAGAIN3PCT

I too have chronic back and abdominal pain. I had 3 DR's that I should give up nursing for disability. I won't. I can't. But I'm back to where I started and I cant use OXY's because I reached toxicity.

Once I realized that fact - that I went from dependent to addict everything became so clear.

I began a dependent. I ended up an addict with a secret life I thought no one knew about..... Until I got here. And Oxyious you always nail that addict pill behavior dead on. I thank you for that today. I need that today. I can't pick up my kids .... But I'm clean. And yet that's just my addict brain being negative and trying to give me an excuses. My kids are big now, not babies, and can climb into my lap.

It is what it is.

Thank you for this post.

Peace & Blessings to you this day!!

3 weeks 1 Day!

Thank Carl.

Thank the Universe.

Off that oxy train for good.

FT

Here's an answer i gave to BeenDownTwoTimes a week or so ago, in answer to the question about what I meant by the "tolerance-dependence-addiction-toxicity" cycle:

Dear BeenDown:

The tolerance-dependence-addiction-toxicity cycle is just a term that gets thrown around to describe the chronological order in which addiction develops. There are some good articles on line, but watch out for people saying things without valid references to actual medical studies and who are only giving opinions.

When I use those terms here, I should probably reference the medical articles to back them up.

My definitions come from this resource, among others:

Donna G. Benedict, MSN, NP, "Walking the Tightrope: Chronic Pain and Substance Abuse" Journal for Nurse Practitioners. 2008;4(8):604-609. © 2008 Elsevier Science, Inc.

This is an article designed to assist medical providers who prescribe opiates to identify who might be prone to addiction. It uses these definitions:

Tolerance refers to the body's ability to adapt to the continual presence of opiate receptor agonists, producing a gradual need to increase the dose to obtain the same amount of pain relief. In chronic pain, this is usually a slow process, and requests for frequent dose escalations are usually considered a red flag. Tolerance to side effects of opiates usually develops much sooner than tolerance to the pain-relieving effects. (In other words, you get addicted to the oxys before the pain effects are gone)

Physical dependence is another compensatory adaptation of the body to the long-term presence of opiate receptor agonists. When the opiates are stopped suddenly, withdrawal symptoms will occur. This is not a sign of psychic dependence, but is to be expected anytime there is an abrupt stop of a substantial dose of opiate therapy. It can be avoided by a gradual down-titration of the dosage before stopping. (according to the article, but many self-medicating addicts fail at doing this)

Addiction refers to compulsive use of a substance for psychic effects and to satisfy a craving for the drug. Behavior includes continuing to use the drug in spite of harm to the user, such as legal problems, damage to relationships, or loss of job. The compulsive need to get high from the substance leads to rapid escalation of the dose, as contrasted to the usual slow need for periodic increases due to tolerance. Addiction is considered to be a chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations

The article warns providers:

"If you prescribe opiates, it is likely that at least a few of your patients are overusing, selling, or combining their medications with illicit substances. Studies show a rate of about 32%." (wow)

This article does not go on to discuss the toxicity that occurs that precedes overdose and death in some patients, probably because the provider is being taught to cut off the addict before they can contribute to the toxicity.

Toxicity simply means that the patient has exceeded the body's ability to detoxify the drug or alcohol, so the toxins are free to go "other places" and do damage to the body. That's why alcoholics develop cirrhosis of the liver, a virtual destruction of the organ. Where the toxicity occurs varies depending on which organ is the detoxifier. Some drugs are detoxified in the kidneys, like some of the NSAID's. In overdoses, the toxicity affects the brain, particularly the breathing centers when opiates are used to toxic levels, and especially if used with benzos.

So that's a little information about the addiction cycle. I'm happy to share the article with anyone who wants it. You can look it up online, but it may be blocked to non-medical users, I'm not sure.

FT

tsmba

You could take this in several directions. I have been dependent on blood pressure meds since age 19. Addiction entails a whole set of negative behaviors on top of dependence.

FT

tsmba:

Yes of course, you are right. That's why the addiction model described above addresses mind altering substances differently from blood pressure meds and the like.

FT

stugotz

Addicts have to go to those "meetings"

MySecretLove

That totally makes sense to me

Roosiedoll

I wish I wasn't an addict...if it's not one thing it's another...sheesh

doggonecarl

When I was dependent on drugs I didn't think I had a problem. When I was addicted, I knew, but didn't care.