bigsombrero

A year ago today I was sleeping in a twin bed next to a brick wall, sharing a room with another alcoholic in a treatment center. I checked into rehab as an alcoholic. It was a joint facility and we had all sorts of folks there - my men's group had a couple alcoholics, a couple crack addicts, a heroin addict and couple guys hooked on pills. Sounds like a nice bunch of lads to introduce your daughter to, eh? Anyway the treatment center had several such mixed groups and I got to know all kinds of addicts.

Something about the differences in addict's attitudes came to mind. I noticed was how much more forgiving the pill addicts were towards their drug. The alcoholics were ANGRY at booze, crack and heroin addicts were FURIOUS at that stupid crap they snorted and smoked.

But the folks addicted to medication, they always stood up and almost defended their DOC. Never did I ever hear one of them say "It's that damn PERCOCET! I just have to drop that garbage!" In fact this particular group of addicts was almost protective of their DOC.

Made me think about recovery styles and how they differ.

As an alcoholic, tapering down rarely works. We tend to like our liquor in bunches and after a while we can't remember if we've had 4 shots or 10. We guzzle and consume, and moderation and measurement are not words in our dictionary. We can't step down the ladder slowly, we have to fall off the roof. Tapering is usually not recommended for us.

But for those addicted to medication, it seems like tapering is more common when it comes to recovery. And it's not just for a week, it's for a long long time. And I wonder if that is healthy? Even during detox, pill addicts still seem very addicted to the process - measuring their intake and carefully counting milligrams. Maybe there is something that is still feeding the addiction there. Tweaking and manipulating their dosages - even as they are getting OFF the stuff - seems to be a very important thing. Measuring and counting seems to be part of the addiction.

Has anyone noticed this difference in recovery style? And the defensiveness as opposed to the anger show by alcoholics? I wonder if part of the defensiveness comes from the opiate originally being prescribed by a doctor? They were told by a professional this was good for them at one point - and perhaps they can't let go of that fact. After all, a doctor told them it was a good idea, right? Does it give the addiction more legitimacy in their eyes? I also wonder if the program of detox (measuring, tapering, counting) is only feeding the addiction a bit?

Just something I wanted to highlight. It's recovery related so I posted it in the "what is recovery" forum. I am certainly not saying alcoholics approach recovery in a better way - we are a hot mess and there's nothing in my trophy case last time I checked. I am just recalling my days in the center, where I was one year ago on this day.

Impurrfect

I've abused alcohol, abused opiates, and got addicted to crack. Years ago, I tried out AA and NA, found my "home" with AA and though I no longer go to meetings, I use what I learned there every day. FWIW, my sponsor was a recovering alkie, but she worked in a treatment center, so she was very familiar with the drugs.

I can only say this...I totally admire recovering alcoholics as their DOC is legal and everywhere. I've never been to treatment, I no longer go to meetings, but I've found just what I needed to hear from people who are addicted to all kinds of things here on SR.

I don't understand the tapering thing, as I quit each thing cold turkey, and with crack...the withdrawals are all mental. I just look for the commonalities and if there aren't any? Well, I just work my recovery and let others work theirs.

I'm not saying there isn't a difference, I'm just saying I had to come to peace with it and "take what you need, leave the rest" and focus on my recovery.

Hugs and prayers,

Amy

Lyoness

To me, tapering is part of the process of quitting but not yet quitting. So yes, people are still addicted and having addictive behaviors. They haven't stopped using yet, they are in the process of getting there.

I think the fact that a drug came from a doctor can and does make a huge difference. It feels like a double betrayal because the doctor prescribed this and it's supposed to help. There is the expectation of help and healing which is not there with street drugs or even alcohol. So it's different. When it turns into addiction it's like both the doctor and the drug lied to and turned on you.

I agree with Impurrfect, though, that each of our recoveries is unique and comparing ultimately serves no real purpose. Take what you need and leave the rest.

Alraihani

Bill Wilson and Dr. Bob were both. I was both (amongst many other things), honestly on the end it's all the same. The circumstances might be different but it had nothing to do with what we were doing. I know alcoholics who scared the **** put of pill addicts with there war stories. As far as tapering off goes, i never was able to do that.

Threshold

It's not clear to me when you speak of defensiveness if you mean they are defensive of their drug (as in it's not the drug's fault they got addicted) or defensive of their addition (boo hoo, it's not my fault, the dr Rx'd me this junk).

For some drugs there are medical reasons for tapering. Had to do with the way the drug effects the body and brain physiologically.

I haven't really noticed the differences that you mention. In anything, I've seen Rx drug abusers sort of shamed faced or feeling like shams because they don't have the credibility of street drug users. Among addicts there is that sick comparison going on..."oh yeah, you were on a pansy drug, you dont know what REAL addiction is." sort of crap.

That BS runs many Rx users out of NA. I had an Rx habit and was actually asked if I really belonged there...maybe I wasn't REALLY an addict. Everyone want's to be more bad a55 than the next guy.

Lyoness

And that is the real tragedy.

I have felt that pressure, mostly from within myself, of not being sure if I was "bad ass" or whatever enough to count. I fell into that trap of wondering whether I was truly an addict. Ironically, the more I used and the deeper in I got, I questioned even more if I was an addict. The denial is/was so powerful that even as a needle addict I have questioned it.

Now when I see people questioning and reaching out for help early in their addictions I try to encourage them and tell them how awesome it is that they are waking up now, sooner rather than later when it gets so much more deeply entrenched and harder to quit.

soberlicious

Not every pill addiction begins with a prescription. I know more than one person whose addiction to pills were never prescribed to them, but bought on the street from the get go. Unfortunately in my area, this is especially prevalent among the teenagers/young adults. Pills are as easy for young people to obtain as alcohol.

I don't see any difference. Addiction is Addiction regardless of the DOC. I think behaviors of addicted individuals vary, sure, but more because of personality, belief systems, etc, not based on their DOC.

Addiction is painful and ugly...all the way around.

bigsombrero

"Addiction is addiction so who cares"...Rats. I was hoping for more inventive answers than that, but it appears that's going to be the most common answer. I do agree to a point...but I would argue that the DOC does affect one's behaviors in a different manner, and thus leads to different approaches to recovery. Just my opinion.

I am not saying it's a huge difference. Look at the big cat family. Sure, there are differences in appearance between tigers, leopards, and lions. They act differently and socialize differently and even hunt differently...but in the end they compare much more favorably to each other than, say, a horse, and more importantly they'll still rip you to shreds and eat you alive so in the end what does it matter?

I know we are often not encouraged to "think too hard" about this stuff because in the end, addiction IS addiction and we can all be killed by this thing. I am just discussing what is on my mind. Tryin' to dig a little deeper, do some critical thinking, and see if anyone else is on my wavelength. It appears not. Oh well, not all posts are winners!

Thanks for reading and responding as always!

Lyoness

I do wonder and have thought a lot about how/whether our type of addiction affects our recoveries. I think of a lot of questions that I would love to do full research studies on if I had a facility and could do so.

But I also think there are just so many differences between us humans as individuals that it can be hard to tease out. I also have a related question that I've thought about most of my life, and that is what makes a person addicted to a particular substance, why do they "choose" that substance, say cocaine, over heroin for instance? Can we figure that out? And how does that then affect recovery? It would be interesting to do a study, to see if it could help people in their recoveries.

Ultimately, though, I always come back to that individuality thing. So I think that's part of why I reach a certain point in answering your question for/within myself that ultimately comes to the point of realizing that the deepest, most important point for me, is just to be in recovery at all. And to try to learn what I can from anyone.

bigsombrero

The former. And that's why I posted this to begin with, I suppose. I think I have seen some Rx abusers post here about cutting down or changing dosages. Example "I am now only taking 20mgs of X, next week I will be down to 15mgs, then next month I will only take 10mgs". And the community meets them with a round of applause. I took a different route and was critical of this and was met with some very vicious and defensive responses.

It's as if it's not the fault of the drug, it's just how they are using it. It's not the Xanax, it's just me not following the doctors orders correctly. I can still use it, just not so much. It's medicine. I'm supposed to take it.

On an alcohol forum, if someone says "I only drank 6 beers tonight", there is no way in hell they'd get much support. If you go to AA and say "I am going to stop drinking vodka and switch to beer" nobody will give you a pat on the back.

And if "recovery is recovery", why does one recovery community support tapering, while another is vehemently against it? In the end I suppose it does not matter, you guys are right on that one. I guess I was feeling comfortable enough for a few days in my own recovery to start peeping around and doing some examinations of others. Probably best to stay in my own back yard, I know when I've wandered too far and maybe I need to get back and cutting my own grass.

soberlicious

No, I don't think it's not worth asking. I think it's a cool question. I just think there is no difference per the DOC. I have seen many (and been one my self) that vehemently defend nicotine as not that bad...uh, yeah, no...it is that bad.

But not everyone who is addicted to pills endorses tapering, I think that's where the discussion falls down for me. I dont believe that one community supports tapering and the other does not. I dont even really see it as different communities, although many do. Many drinkers try to "moderate" which is a clumsy way to try to taper. I also see replacement therapies as a form of tapering. Lots of people who are addicted to drugs other than alcohol advocate CT. And see tapering as a continuation of the addiction.

I do think that CT is perceived as "harder" than tapering by some people, but I really think that belief is a function of addiction.

DylanS

CT from benzos can be dangerous and tapering is advised.

I know that, for me, being both an alcoholic and opiate addict, staying away from the opiates is much, much harder. Perhaps it's true for others as well, and why some folks taper and/or use Suboxone to get off opiates.

A buddy of mine was on oxycontin and oxycodone for 3 years and successfully tapered off. I can't taper - it's too much of a tease.

soberlicious

CT from alcohol can also be fatal.

A medically supervised detox is different than a prolonged taper.

JenEss

As a former painkiller abuser, I can tell you that pain was a great fear of mine..in every form. I've learned that a lot of prescription pain med abusers are in a lot of emotional pain.
For years I wanted to do the "easier, softer way" of tapering off, but it was always disastrous. The fear of withdrawal pain was almost unbearable. Getting sober this time, I just went cold turkey off of everything.
I think the defending thing is just the complete denial we get ourselves into. We keep telling ourselves that our addiction isn't really that bad because, heck...doctor's give these things out and they are legal. I've been guilty of the same thing even though I was an IV user. It's very sick and twisted.
And you're right about the dosage thing. It all becomes part of the pill addiction process. The counting and measuring. That's why tapering is a bad idea. It's a tease.

Hope that was helpful.

JenEss

I wanted to add something..
I don't think the recovery community supports tapering so much as doctors support it.
Doctors support it because there is more money in us being on meds than not. Communities tend to follow suit of the medical industry.

bigsombrero

JenEss, thank you for your responses! I think your input brings up very good points and it was really helpful and honest in the discussion.

I have checked today on posts concerning Rx abuse, and very easily I found that there are very recent posts with members describing tapering. They list dosages, amounts, what they were taking, what they are taking, counting, etc, etc. And they are getting plenty of support.

I am not sure what to think. After all, I was not addicted to Rx meds...so perhaps I don't understand and should stay away? Then again, many here have said "addiction is addiction", so perhaps in that vain I do have a right to be curious. So is this none of my business? I am an addict after all. Like I said I mainly started this because I noticed similarities between posters here and my fellow inmates in the rehab center, specifically when it comes to Rx. And as I'd said before, trust me, alcoholics are no better, and I am a member of that group.

cleaninLI

Let me just add my two cents, there is a difference between psychological addiction and physiological addiction.
I think we all know the differences.
When a person is taking oppiate painkillers the body becomes physically addicted to the medicine when the meds are abruptly discontinued the body goes through a shock causing very uncomfortable withdrawal symptoms. Since doses can be adjusted to avoid this shock to the body many addicts who are physically addicted taper off their medications. Of course not all addicts can taper, especially those that are psychologically addicted. There is no choice but to go cold turkey and suffer through WD.

Some meds such as benzos (Valium, Xanax, etc) should be tapered, otherwise life threatening WD can occur.

Now, many of the threads in the subs abuse forum where you might see taper schedules and that sort of thing are created by addicts who are med prescribed suboxone or methadone and are not to be confused with other oppiate meds. These are specifically prescribed to either combat WD symptoms or for addiction recovery maintenance meds. Not unlike anti abuse or naltrexone given to alcoholics to combat cravings. These do not cause a "high" Since there is no high associated with these meds addicts can and are able to wean off these meds. These must be tapered or very severe WD could occur.

I spend the majority of my time in the substance abuse side of the forum and I see numerous threads /posts from addicts who are very angry with those da!m pills or doc. They refer to them as "devil" pills and many other derogatory names. I have read posts where addicts struggle with anxiety or pain while trying to get off the meds that were prescribed for those reasons. I have also read posts where alcoholics struggle with being at parties where alcohol is served or giving up their social lifestyle.

Bottom line is that addiction is addiction. The doc makes no difference. The recovery process is the same for addicts/alcholics. In fact the majority of addicts substitute their docs. Many addicts become alcoholics and vice versa or are addicted to both.

Even the healthcare community recognizes it as the same. Which is why you were in the same rehab facility.

As always take what you want and leave the rest.

soberlicious

Again, I do think there is a significant difference between a medically supervised detox (which may include some tapering) with a specific, and fairly quick endpoint, and an addicted individual trying to taper themselves off any drug that they are currently dependent on either physically, psychologically, or both.

Of course no one wants to suffer, but there are withdrawal symptoms that are uncomfortable. There is nothing pleasant about withdrawing from a drug. That's just how it is.
Replacement therapies are highly controversial.

Lyoness

I think it depends on how one is tapering. I am using suboxone to taper off my opiate addiction. It is a medically supervised taper and is saving my life. I have tried to taper on the other opiates and tried cold turkey and fail at both. I cannot handle the pain of cold turkey and also don't want to harm my body by going through it again. Withdrawals are HARD on a person's body, they do damage, and I don't want do that to myself. If someone else can, I think that is awesome. But I can't.

I know some people really disagree with this and would say I am in active addiction and not in recovery at all. I disagree. I AM in recovery, I struggle with it every day. I don't get high off suboxone, I am not trying to get high off it. I am trying to get off a life threatening addiction and believe using suboxone is my best chance to do it.

Lyoness

I found myself thinking like you did, as well. Questioning whether I was truly addicted even though I was injecting and insufflating my drugs. I think that maybe by being prescription drugs it adds another, or maybe just a different angle of the massive denial that each and every addict deals with.