Addiction versus Tolerance

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straydog
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   Posted 11/16/2007 3:07 PM (GMT -7)   
Hello Everyone,
 
I was reading in WebMd some things last night and I would like to share what they have written about addiction to opiods.
"You may become physically dependent on opiods if you take them regularly. Physical Dependence is not addiction, but rather a gradual change in your body in response to opiods."
 
I know we have had numerous discussion on the forum about addiction issues. WebMD confirmed for me what many of us have said all along, our bodies become tolerant to a drug, whether its a blood pressure pill or a pain pill.
 
I just wanted to share this to remind people on here that we are not addicts. Hope all is having a better pain day, yeppers, we have them too.........Susie
 
 


TinaK
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   Posted 11/16/2007 4:39 PM (GMT -7)   
Thanks for the reminder Susie. I have been taking narcotics for over 6 years and will continue for probably the rest of my life. Yet, I sometimes feel like an addict. I am not but every once in a while, a doctor, a nurse, in the ER, or a new pharmacy tech will give me the look and make me doubt myself. I wish I could live without them but I can't. It took me a long time to accept that.
Thanks for your supportive words in a world that can sometimes be demeaning.
TinaK


straydog
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   Posted 11/16/2007 5:12 PM (GMT -7)   
Tina I have been on medication for 5 yrs now. I have a Pain Pump but still am scripted Dilaudid for the BT pain. I am really down in my back right now and I back to clock watching, jeez, I hate. But, I am following my dr & nurses instructions and I am taking my BT trying to get the pain under control, I am not there yet. I even had a pump refill & increase last week and I still hurt. But, I will get there eventually. Lots of hugs, Susie


TinaK
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   Posted 11/17/2007 11:34 AM (GMT -7)   
Susie,
Like you, I have Crohn's disease and most of my pain is abdominal. I have had five surgeries, two for colon resections, three for adhesions. The doctors say they won't do any more surgeries for adhesions unless I am obstructed. Needless to say, when I am flaring, my pain is worse. What is going on with your back? I am currently taking Opana ER and percoset for BT. It works most of the time. Are you glad you had the pain pump put in?
I have a feeling that could be in my future but it seems so drastic.
Hope you are feeling better soon. Take care everyone, Tina


curley
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   Posted 11/17/2007 9:19 PM (GMT -7)   
Susie thank you for reminding us.I hope that you get to feeling better soon.

Curley
.........
 


Chutz
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   Posted 11/18/2007 12:18 PM (GMT -7)   
Great post Susie! Thanks for taking the time to post.

Hugs,
Chutzie
Co-Mod Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, collapsed disk, dermatitis herpetiformus, osteo arthritis in spine and other locations.
***************

The only difference between genius and stupidity is that genius has it's limits. Albert Einstein: (1879-1955)


Howlyncat
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   Posted 11/19/2007 8:00 AM (GMT -7)   
Thanks Susie

Great post and truly needed..........

Luvs
LYN
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straydog
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   Posted 11/24/2007 10:24 PM (GMT -7)   
Tina, you asked about my back, well, I finally figured out what was going on. I have a pool in my back yard and the house behind me has a big silver leaf maple that is shedding its leaves right into my pool. I have to keep the leaves out of the pool, otherwise the skimmers fill up and get blocked and you can burn a pump up. In addition I was raking leaves in the yard and was over doing it. I switched from my pain pills to my muscle relaxers and they have made all the difference in the world. As long as I stay with the muscles relaxers its much moe tolerable. Hugs, Susie


Howlyncat
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   Posted 11/25/2007 9:37 AM (GMT -7)   
Susie

Glad you finally go it all figured out and that the muscle relaxers are helping

Take care and try not to be over doing it anymore ...........

Have a good day

LYN
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TinaK
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   Posted 11/25/2007 9:46 AM (GMT -7)   

Susie, how is your back feeling now?   Is it getting better?  Glad to hear the muscle relaxers are working for ya!  I know for me when I have a good day, I can over do things and then have to lay low the next day.  It is such a balancing act.  Hope you are doing better every day.

Take care,

Tina



getting by
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   Posted 11/25/2007 2:17 PM (GMT -7)   
Thank you Susie for posting that, it is nice to hear. But the thing we are concerned about being labeled is being an abuser. I hate telling anybody I have to take narcotics for pain, it seems like some people automatically label you as a drug addict. And I think after years of use we not only build up a tolerance (actually that can happen rather quickly) but we do become addicted, have you ever forgotten to take a dose? I have, especially if I am not feeling that bad at the time. But I dearly pay for it when I realize what I have done. It also takes longer for the pain killer to take affect. What a never ending circle. Though without pain medications I don't know what I would do. I am able to live a halfway normal life now and I wouldn't give up my medications if my life depended on it.
Wishing you a painfree evening,
hugs,
getting by
fibromyalgia, chronic fatigue, clinically depressed and allergies


TexasJen
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Date Joined Dec 2006
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   Posted 11/25/2007 4:26 PM (GMT -7)   
getting by - I think you still have addiction and tolerance a bit confused. When we must take narcotics regularly, we build up a tolerance and we will experience withdrawal if we stop taking the meds, or as you experienced, miss a dose or two. Experiencing withdrawal has nothing to do with addiction.

Tolerance is a physical issue. Addiction is a mental issue. It's that simple. If a person craves the narcotics for the feeling of getting high, and takes them to maintain that feeling, then that person is an addict. If a person takes these meds more than prescribed, or crushes, snorts or takes them in any way not directed by a doctor, then that person is an addict.

It's confusing for many of us with chronic pain issues when we have to take narcotics and go through withdrawal for the first time. Not only do we label ourselves as addicts, but our family members and friends do as well. It's all due to simple ignorance. Some people are willing to listen and be educated about opiate therapy; others are so stuck in the "narcotics = addict" propaganda and they just won't be educated and will never change their minds. Shoot, I've run across plenty of so-called medical professionals who are like that. You just have to reach a point of acceptance and not let their labeling ruin your day. Yes, even if it's a family member. All you can do is try to rationally explain the issue, and if they won't listen - well, there isn't anything else you can do.

I've always felt my health issues and treatment were nobody's business, so I don't advertise anything that might leave me open for an argument. Makes life a whole lot easier. :-)
Living in the Republic of Texas minus a gallbladder, a couple of cervical discs, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


getting by
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   Posted 11/25/2007 5:44 PM (GMT -7)   
Jen,
I think that some people are afraid of being labeled as an 'addict", when it gets mixed up with abuse. What you described to me sounds more like abuse than addiction. Though it could be both. But not all drug abusers are addicts and not all addicted people are abusers. I know I am addicted to some of my antidepressants. If I ran out of them I would go through serious withdrawal symptoms, and the same with my pain medications. My body and my mind are both use to the chemicals in them and my body is addicted. With out my medications I could not function at all.
Building up a tolerance is when the medication does not work for you any more, it is like you become ammuned to it. So therefore you have to increase the dose. With this eventually you do become addicted, but you are not becoming abusive.
I think that you can come addicted to chocolate. Caffiene. Sleeping pills, but you aren't abusing them.
I don't think we should be so afraid of "labeling", like you said it is nobodies business but our own. And if we are abusing, we know it. If I can feel "good" when I take my pain medication, am I addicted or am I just feeling "pain relief"?
Don't think that junkies aren't going though some serious physical withdrawal when they are jonesing? They go through pain, runny nose, irratbility, etc. Both physical and emotional.
I am not trying to argue, it is just such a fine line. And just because we need pharmacological help, doesn't mean we are bad people or that we are druggies. We are just in pain.
hugs,
getting by
fibromyalgia, chronic fatigue, clinically depressed and allergies


straydog
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   Posted 11/25/2007 7:21 PM (GMT -7)   
It is a fine line in a sense but in no way am I an addict because I take opiates and an antidepressant. If I don't take my chill pill and let it go over a day I don't ballsitic or go into w/d, I just feel weird. Thats because of the drop in my serotonin? level.

I truly believe the fewer people that know your business the better. I offer no explanations because none are due in my mind. I don't want people to know about my medicine mainly because I don't even want to be asked for a muscle relaxer. Susie


getting by
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   Posted 11/25/2007 8:10 PM (GMT -7)   
I feel the same way as you do. The less people know about what I take the better for me. I just don't know, I guess unless you go through it, you don't understand. I just hate all of the labeling. I know there are more and more people with chronic pain so more people are understanding. But there are the few judgemental people, who cares. We do what we have to to cope with the everyday pain.
I take effexor as an antidepressant, if you ask anybody who takes it, they will tell you it is short lived in the system. If you miss a dose, maybe the seratonin level has something to do with it, you do go through a withdrawal symptom, it is like you are falling off of the face of the earth. It is still a withdrawal. A missing brain chemical.
getting by
fibromyalgia, chronic fatigue, clinically depressed and allergies


keepingthefaith
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Date Joined Aug 2006
Total Posts : 331
   Posted 11/26/2007 12:42 PM (GMT -7)   
I have a question for you guys...if you have been on the pain meds for so long, what do you do when it no longer helps you function.  I mean, once you do have the tolerance to it?  Also, I agree with all your comments,  do you think people would still label us if our pain med was called something else, i.e., something that there isn't a prior label for.  Just a question.  If we called it something no one heard of before, I bet their additude towards us would be different.  It would be just another medication for our illiness/injury.  I struggle with taking pain meds too.  It kills me that I can only function with them.  My fatigue level is so high & my meds give me energy along with taking all the aches & pain away.  But cuz there is that stigma, I do have a hard time accepting that I need them.  When I stop taking them, my body hurts all over & then I remember why I need them.  God Bless 

Dx with CD 1987, 3 resections, 3 abcess sx, OA back & hips, bulging disk, Major depression/anxiety, kidney stones & sx to remove, now 44 yrs old.  Still trying to figure this disease out & of course all the little extra complications that come with this rollarcoaster of a life with CD. 
 
Meds:Humira 40mg every other wk, Imuran .75 daily, welchol 625 x 3 daily, cymbalta 60 mg daily, norco 10/325 x 4x, fish oil, vit e,folic acid,Vit B12,inject monthly,
 
         
 
 


getting by
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   Posted 11/26/2007 1:35 PM (GMT -7)   
When the pain medication quits working for you, normally you would have to go to a higher dose or a stronger medication. I noticed that you take norco 4Xa day. If that is the medication that you are refering to, I would tend to think that they will go to the next step up which I believe to be most likely oxycodone. You have plenty of room yet before you have to worry about running out of strengths. I have heard that there is a type of hydrocodone in other countries that is continous release, but not in the United States. I wish there was here because I take it four times a day too and that would help from having to take so many times. I have other meds that I have to take frequently and I feel like a walking pharmacy.
I hope that this helps you,
getting by
fibromyalgia, chronic fatigue, clinically depressed and allergies


keepingthefaith
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Date Joined Aug 2006
Total Posts : 331
   Posted 11/26/2007 1:47 PM (GMT -7)   
Getting by, thanks for your reply.  What do you mean by "plenty of room yet before running out"? 

Dx with CD 1987, 3 resections, 3 abcess sx, OA back & hips, bulging disk, Major depression/anxiety, kidney stones & sx to remove, now 44 yrs old.  Still trying to figure this disease out & of course all the little extra complications that come with this rollarcoaster of a life with CD. 
 
Meds:Humira 40mg every other wk, Imuran .75 daily, welchol 625 x 3 daily, cymbalta 60 mg daily, norco 10/325 x 4x, fish oil, vit e,folic acid,Vit B12,inject monthly,
 
         
 
 


getting by
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Total Posts : 40569
   Posted 11/26/2007 6:07 PM (GMT -7)   
keepingthefaith,
You are, like myself, at the lower end of the opiate scale. If we build a tolerance to the norco, there are still a lot of options. Hydrocodone is one of the weaker narcotics. If you start taking a lot of medications and keep going higher towards the strongest, eventually they will do you no good. I have a friend with non-hodgkins lymphoma and he has to take 200mg of morphine at a time for it to kill his pain. That is a lot. There is a lot of room in between.
I hope that you can understand what I mean. I am not that good at explaining things.
getting by
fibromyalgia, chronic fatigue, clinically depressed and allergies


keepingthefaith
Regular Member


Date Joined Aug 2006
Total Posts : 331
   Posted 11/26/2007 6:57 PM (GMT -7)   
I understand what you mean now, thank you very much. 

Dx with CD 1987, 3 resections, 3 abcess sx, OA back & hips, bulging disk, Major depression/anxiety, kidney stones & sx to remove, now 44 yrs old.  Still trying to figure this disease out & of course all the little extra complications that come with this rollarcoaster of a life with CD. 
 
Meds:Humira 40mg every other wk, Imuran .75 daily, welchol 625 x 3 daily, cymbalta 60 mg daily, norco 10/325 x 4x, fish oil, vit e,folic acid,Vit B12,inject monthly,
 
         
 
 


Gloriousm84
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Date Joined Nov 2007
Total Posts : 114
   Posted 11/29/2007 11:47 PM (GMT -7)   
Thank you I am glad someone else (or many people in this case) know the difference between addiction and tolerance. I was recently in the hospital for a crohns exacerbation and the doc wrote a note to my GP saying I was just narcotic seeking. This is the doc that prescribed me 1-5mg dialudid one day and then the next day moved me to percocet every 6 hours. What? talk about a change...and 5mg of dilaudid could take out a bear. Good times with people thinking you are seeking drugs just for the fun of it.
Diagnosed: 2003, age 18 (had issues with it since I was 12)
Meds for crohns: 20mg Prednisone, 9mg Entocort, 400mg Remicade, 50mg 6-MP, 40mg Prilosec, 1mg Folic Acid, 5/325 Percocet.
Other medical issues: Hereditary Spherocytosis (hemolytic anemia) iron deficient anemia, polyarthralgia, ovarian cysts, Migraines
Surgeries: Spleen and gallbladder out at age 6, Tonsils and Adenoids out at age 21. Looking at resection surgery this year.


keepingthefaith
Regular Member


Date Joined Aug 2006
Total Posts : 331
   Posted 11/30/2007 10:16 AM (GMT -7)   
Hope you are feeling better! God Bless

Dx with CD 1987, 3 resections, 3 abcess sx, OA back & hips, bulging disk, Major depression/anxiety, kidney stones & sx to remove, now 44 yrs old.  Still trying to figure this disease out & of course all the little extra complications that come with this rollarcoaster of a life with CD. 
 
Meds:Humira 40mg every other wk, Imuran .75 daily, welchol 625 x 3 daily, cymbalta 60 mg daily, norco 10/325 x 4x, fish oil, vit e,folic acid,Vit B12,inject monthly,
 
         
 
 


TexasJen
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Date Joined Dec 2006
Total Posts : 649
   Posted Yesterday 9:56 AM (GMT -7)   
One other strategy that some pain docs use in order to avoid increasing dosage or moving to stronger meds, is to stay within roughly the same class of drug, but rotate it every few months. For example, maybe use Norco for 4 months, then percocet for 4 months, then Tylenol 3 for 4 months. Sometimes slightly changing the chemical helps fool the brain and reduses tolerance issues.
 
[Edited to add:]  Another strategy for tolerance issues is to take a drug holiday.  The patient is weaned either completely off the meds or to a very low dosage for a few weeks to allow the pain receptors in the brain to reset and get cleared out of the opiates.  Yes, you'll hurt for a while, but if tolerance is a huge issue, it's just something that must be suffered through.  Once the patient goes back on the meds, he can start back at a lower therapeutic dose.


Living in the Republic of Texas minus a gallbladder, a couple of cervical discs, appendix, uterus, and 18" of colon; but still alive and living with my husband, 2 dogs, 1 cockatiel, and 2 gold fish. 

Post Edited (TexasJen) : 12/3/2007 9:55:44 AM (GMT-7)


keepingthefaith
Regular Member


Date Joined Aug 2006
Total Posts : 331
   Posted Today 12:38 PM (GMT -7)   
Sounds like a good plan.  I'm going to try it. 

Dx with CD 1987, 3 resections, 3 abcess sx, OA back & hips, bulging disk, Major depression/anxiety, kidney stones & sx to remove, now 44 yrs old.  Still trying to figure this disease out & of course all the little extra complications that come with this rollarcoaster of a life with CD. 
 
Meds:Humira 40mg every other wk, Imuran .75 daily, welchol 625 x 3 daily, cymbalta 60 mg daily, norco 10/325 x 4x, fish oil, vit e,folic acid,Vit B12,inject monthly,
 
         
 
 


2BFREE
New Member


Date Joined May 2007
Total Posts : 4
   Posted 3/3/2008 7:32 AM (GMT -7)   
Sad but true if you have been on nacotic pain medication for a very long time,your tolorance will be great. Also the reason for meds to be adjusted { e> i> Increased dose or somthing stronger} Is because not only have you satisfied your receptors,but now you have more of them to satisfy.
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