This is a quick, but informative short video for those that are just now learning more about their backs and spines due to pain, Degenerative Disc Disease, or a Prolapsed, (or Bulging) Disc.
http://www.healthcentral.com/chronic-pain/symptom-checker-24-115.html?ic=4042
From Health Central.
Monday, April 27, 2009
Saturday, April 18, 2009
Addiction, Dependence, Tolerance-Part 2
Now to continue to the 2nd half of my posting on these three words in the Chronic Pain patients life: Addiction, Dependence, and Tolerance. You may remember we stopped at talking about Tolerance. When we have become quite accustomed to the dosage of, or the medication in general that we have been on for a long time stops being effective on our pain; then we have become tolerant to this, and this requires needing a change in the medication. This does not in any way mean that we have become addicts and are seeking a high, we have simply become accustomed to the medication in it's effectiveness on our pain. Tolerance simply means that we are used to the exact amount that we are taking of a medication. Our receptors are still working fine, but physiologically, we have passed the threshold in which what we take -no longer equals pain relief. Again, this has nothing to do with addiction. I am talking about PAIN. Not about seeking a high. This is strictly about how our pain has surpassed the medication's ability to control it.
One situation in which a pain patient can resemble an addict's behavior, is when their pain is not controlled, and they are unfortunate to have not found a doctor that either believes their pain, or they have not yet met up with a pain specialist that would immediately hear what they have to say, and know they are in true pain; and so their behavior may resemble that as of an addict. They ARE focused on medications. But it is NOT for the euphoria. It is for the management of their pain. Anything to stop it--to take it away!!! When pain is left untreated, uncontrolled, the patient with chronic pain of course will focus on the medications, because they are not getting what the pain receptors in the body need to stop the pain; to block it. This is a sad situation, frustrating for the patient and doctor alike. My heart truly goes out to these untreated pain sufferers. Of course some must resort to the ways that addicts obtain their chosen drugs for their euphoria, while the pain patient is looking for something---anything, that will stop this monster called pain.
That is why I feel so blessed to have first found a world-renown Medical Center to treat my pain for 4 years, (after the last and final surgery that failed after a year of seeming success; and has now become Failed Back Surgery Syndrome), then I found the Medical Director of a Pain Rehabilitation Center, and have been with that doctor for the last 5 years. These doctors believed me for starters, then treated me as a human, and understood that when my pain would get worse over a number of weeks, without any change in lifestyle; we both knew that I was becoming tolerant to that medication, and it was time to change it totally, or as said before, change the dosage, or the frequency to see if that will break the increased pain. Of course it is not always about just the medications, it can be that your basic problem(s)/diseases/diagnosis, are causing you to have increased daily pain, and it has become worse, i.e., my Severe Thoracic Spinal Stenosis has begun to squeeze the cord a bit more daily, the Osteophytes, (pieces growing off of vertebrae), and into my cord are busy doing what they do--grow, and the pain into the spinal cord from them are causing an increase in my pain levels.
Then enter Dependence. This is when the body is so used to a certain medication(s), that an abrupt stop of that med will bring on withdrawal symptoms. It is a simple and straightforward issue. It is dangerous, and life-threatening. My next post is going to be on the importance of wearing a medical ID bracelet, and being a chronic pain patient that
takes everyday medications; this is an Emergency if you can not speak for yourself, and the Emergency Department knows nothing of your medications, and if they abruptly stop them--inadvertently, the withdrawal symptoms begin. Dependence can also be present in an addict. If they have been taking their non-prescribed medications for quite awhile, then suddenly their connection stops, they get caught at their place of work if they have access to medications, or their 'friend the doctor' stops writing them illegal scripts, of course they will go into a withdrawal, for they, too, are dependent on a medication.
Usually not just one doctor is involved in an addicts life, as addicts are well-known for 'Doctor shopping'; for addicts are after the HIGH, and they are not after taking any physical pain away, so without being followed properly and legally by a doctor, they 'prescribe' themselves their own cocktail of medications, taken in a variety of methods: oral, IV, IM, snorting, smoking, or any other way that works for any certain drug they were able to obtain, under whatever circumstance. These addicts are at high risk also in a situation when they can not talk in an Emergency, and the meds are not given, they have become dependent in their physical system, and will begin to go through withdrawals.
So, as a pain patient, we haven nothing to do--AGAIN-- with the word Addict, we experience Tolerance, and we can have the chance of going through the utter hell of Dependence in it's worst form; if it takes us through the world of unnecessary withdrawal symptoms; which should not happen, only unless the patient is in a situation in which we can not vocalize what medications we are on, no one is there to tell the doctors, (here it is good to point out that a list made of your most recent meds taken is with someone you trust, hopefully, the person on your Emergency list,) and that they are not to be stopped abruptly. Wearing a Medical ID Bracelet will have the prescribing doctor's name and phone number, so they can be contacted immediately in case of an emergency. The addict does not have the ability to wear an ID bracelet, as there is no doctor to put down, since they have been obtaining their drugs illegally due to their illness-- which is the disease of addiction. In the sad disease of addiction, I feel sorry for the addict in the ED. They are not well-liked in the ED, and at times are even treated as 2nd class citizens. When the nurses and docs see the IV insertion marks, they are angry because this person, although sick, and needing help such as admission to a rehab center, is one that makes it all so hard for the real people that need these types of medications to get them! And what our poor doctors go through to even be able to write the script without fear of FDA reprisal. Any doctor that randomly prescribes pain meds is just simply asking for trouble, and plays a huge part in the world in which the pain patient must live. And in a very negative way. It is like a chain--(that we may be unfortunately caught in somewhere), the docs that are helping the addict by writing the unneeded script, the addict fills and uses them, somewhere along the line the two are put together and caught, (hopefully, and usually only if there is a pattern between a certain doctor and a certain person), yet the doctors with true empathy and care of the patient that suffers from real pain must write Security prescriptions for the Opiates, which the FDA follows closely; we, (the pain patients), must wait exactly 28 days for the script, keeping us from over-using the medicines, and keeping the FDA happy, and from there it repeats itself every month for us pain patients.
It is easy and very interesting to go to the website that licenses anyone who needs a license to work--go to the doctors area, and you may be shocked at the amount of them who are on the list of those who have either lost their license to practice, or have had it suspended, and what is the most surprising to me, is the reason why these docs have gotten into that situation. Yep! Writing unneeded prescriptions, writing a very large amount of pain-medication scripts in a practice of non-pain-related work, such as a Family Practitioner or an Internist; and a variety of other things, including sexual harassment, etc., but for the most part, is has to do with that little pad that many feels makes them a God of some sort. Many doctors do NOT have the ability to write Security prescriptions, they are not able to obtain the pad, as along with being scrutinized in their background, the FDA decides if that doctor works in a chosen field that would require them to write no more than Vicodin, for short-term use. The docs who have the special Security prescription pad have earned it, work in a pain-based area with pain patients, and now have to take a test for EVERY TYPE OF MEDICATION THAT THEY ARE PRESCRIBING. Oh, a waste of time? I am split on that feeling. It keeps the easily-swayed docs out of that group, and keeps in those that are truly serious about prescribing a strong medication for a patient that truly needs it. There is a good reason for both.
So, our lesson tonight: Addiction, Tolerance, and Dependence are words that need to be understood by all pain patients. Remember, the more educated we are, the better we communicate with our doctors, and they are our gateway to a life in the least amount of pain as possible, without being knocked out all day. It is a game of trial and fine-tuning. This does not happen overnight, and changing meds can be one of the hardest attempts we pain patients must make at times, to find that as-close-to-perfect dose of meds. I once changed my main pain medication, to really feel what my days would be like using a new and much more 'easy use' of medication administration to myself. It was truly hell. Yet I wanted to ride it out, give the new one a chance, and see if it would work. I could truly not believe how horrid my pain was. I had no idea it could get so high. It set for me, a new pain scale after feeling that. Now a 9 out of 10 (9/10) on the pain scale is a 7/10 after that experience. I ended going back to my old med, at a different dose, and I was amazed just how well it really did work, until I had gone without it while trying something new. I was NOT HIGH. I was NOT EUPHORIC. I was NOT having fun. It was the worst time pain-wise for me, save for after my double fusion with 2 rib heads drilled out, that I have ever felt. I would not wish that on anyone.
I have said myself, and heard others also, say," I wish I could get a buzz off these meds sometimes." When the pain is so high, and the meds are not working well that day due to who knows why, or we overdid it and don't have enough spoons left, (Hi Christine!); it would truly be nice to feel relaxed and happy at that time. Forget the pain. But we are not addicts. And our pain receptors are using the medications for just that---to block pain. We don't get the buzz that addicts get; their pain receptors are not asking for anything, and they get the medications straight to the pleasure center of the brain. Our pain-filed bodies just don't work that way.
Well, my body is now in pain, as I have been sitting here too long and it is time for my heating pad and answer an important call. I am high off of the fantastic tacos my friend made tonight, and those beans--so creamy....and I can't do one dam thing about my pain right now. Hormones have become my true enemy lately, and for about one week before my period, I get pain levels that have been 9/10 the minute I open my eyes, making little grunting sounds as I make coffee, and then the usual routine, take meds, sit on heating pad, and wait for the effect of both to hopefully take effect. I always get some relief, if even just for an hour; but for the pain to go down to a 7 then up to a 9 again within 4 hours is not what I call relief. But I am not going out searching for anything. I just need to search for the time tomorrow to call my pain doc; for it is med time, appointment time, fill those meds time, and then do it all over again the next month. Addicts may dreamily say how nice that must be. But I'm not a woman with a disease such as addiction who swallows or shoots up drugs to get high. I am a woman with a disease called severe Thoracic Spinal Stenosis, (my spine is being slowly 'crushed'), I am a woman with the disease of bone fragments growing out from the vertebrae and straight into my cord, and I am a woman whose pain causes nothing but empathy from my family that care about me, my friends whose desire is to be able to walk a mile in my shoes so they can understand what it is I feel every day, (I have a feeling they'd stop at a 1/8 mile), and a woman whom my fellow bloggers who do know what it feels like, give me true support and more empathy.
And THAT helps the pain--if even for a moment, if even in my mind, taking the focus onto other things.....
Anything but that pain.
Remember WHO and WHAT you are. We may never get our world or the people in it to understand exactly what it is that we MUST DO to live with everyday pain. And I just don't care anymore about wasting my time in doing that. I am done explaining, cajoling, talking into, about my medications. Let them all think what they want. As I've said before, I surround myself with those who do not judge me or require any type of explanation about my life. Just please don't put the word ADDICT in the same sentence when talking about my pain, and what I have chosen, and need to do so I can have a semblance of an actual life. Please.
Just remember we are pain patients. Not above or below anyone. It is just the hand that we were dealt. I've played enough card games in my day to know this:
I don't care for this hand!! Can I go fish??
BTW, my pain doctor told me yesterday (yes, this has taken me more than one day to write), that the recovery of my hand and arm were known to take 1 centimeter per month to heal. Whaaaaaaat? I asked doc...did you say month??? So we counted out where my numbness starts, how my ability to NOT hold onto things is, and how many centimeters it would take to equal a year.
I've got some time on my hands. My HANDS, get it?? hehe
I hope that the explanation of the words Addiction, Tolerance, and Dependence have been of some help to those pain patients that take strong medications. We do NOT need to explain our choices to anyone!! Just make sure you have someone who you trust to talk to about this issue. To give you a close and honest feedback of how you seem to be handling your meds.
It rarely gets out of hand, but it's good to hear that from someone who truly loves you. Your doctor, the one whom you have a very close and also honest relationship with, should be told everything when it comes to the taking of your medications. They see you for a 1/2 hour every month, every 2 weeks, whatever your schedule is. Thus the reason for that pain journal!! It's hard to remember the last month or 2 and relate it all in a half hour.
Let's take a pro-active stand on taking medications. We have the right, the reason, and the need. Let the addicts get jealous and angry. For they are not us. We are not them. And most of all, let us keep, and STRENGTHEN the bond we have with other people in pain. There is no other group of people than those who feel exactly what we do, to truly care.
Gentle Hugs...<3
One situation in which a pain patient can resemble an addict's behavior, is when their pain is not controlled, and they are unfortunate to have not found a doctor that either believes their pain, or they have not yet met up with a pain specialist that would immediately hear what they have to say, and know they are in true pain; and so their behavior may resemble that as of an addict. They ARE focused on medications. But it is NOT for the euphoria. It is for the management of their pain. Anything to stop it--to take it away!!! When pain is left untreated, uncontrolled, the patient with chronic pain of course will focus on the medications, because they are not getting what the pain receptors in the body need to stop the pain; to block it. This is a sad situation, frustrating for the patient and doctor alike. My heart truly goes out to these untreated pain sufferers. Of course some must resort to the ways that addicts obtain their chosen drugs for their euphoria, while the pain patient is looking for something---anything, that will stop this monster called pain.
That is why I feel so blessed to have first found a world-renown Medical Center to treat my pain for 4 years, (after the last and final surgery that failed after a year of seeming success; and has now become Failed Back Surgery Syndrome), then I found the Medical Director of a Pain Rehabilitation Center, and have been with that doctor for the last 5 years. These doctors believed me for starters, then treated me as a human, and understood that when my pain would get worse over a number of weeks, without any change in lifestyle; we both knew that I was becoming tolerant to that medication, and it was time to change it totally, or as said before, change the dosage, or the frequency to see if that will break the increased pain. Of course it is not always about just the medications, it can be that your basic problem(s)/diseases/diagnosis, are causing you to have increased daily pain, and it has become worse, i.e., my Severe Thoracic Spinal Stenosis has begun to squeeze the cord a bit more daily, the Osteophytes, (pieces growing off of vertebrae), and into my cord are busy doing what they do--grow, and the pain into the spinal cord from them are causing an increase in my pain levels.
Then enter Dependence. This is when the body is so used to a certain medication(s), that an abrupt stop of that med will bring on withdrawal symptoms. It is a simple and straightforward issue. It is dangerous, and life-threatening. My next post is going to be on the importance of wearing a medical ID bracelet, and being a chronic pain patient that
takes everyday medications; this is an Emergency if you can not speak for yourself, and the Emergency Department knows nothing of your medications, and if they abruptly stop them--inadvertently, the withdrawal symptoms begin. Dependence can also be present in an addict. If they have been taking their non-prescribed medications for quite awhile, then suddenly their connection stops, they get caught at their place of work if they have access to medications, or their 'friend the doctor' stops writing them illegal scripts, of course they will go into a withdrawal, for they, too, are dependent on a medication.
Usually not just one doctor is involved in an addicts life, as addicts are well-known for 'Doctor shopping'; for addicts are after the HIGH, and they are not after taking any physical pain away, so without being followed properly and legally by a doctor, they 'prescribe' themselves their own cocktail of medications, taken in a variety of methods: oral, IV, IM, snorting, smoking, or any other way that works for any certain drug they were able to obtain, under whatever circumstance. These addicts are at high risk also in a situation when they can not talk in an Emergency, and the meds are not given, they have become dependent in their physical system, and will begin to go through withdrawals.
So, as a pain patient, we haven nothing to do--AGAIN-- with the word Addict, we experience Tolerance, and we can have the chance of going through the utter hell of Dependence in it's worst form; if it takes us through the world of unnecessary withdrawal symptoms; which should not happen, only unless the patient is in a situation in which we can not vocalize what medications we are on, no one is there to tell the doctors, (here it is good to point out that a list made of your most recent meds taken is with someone you trust, hopefully, the person on your Emergency list,) and that they are not to be stopped abruptly. Wearing a Medical ID Bracelet will have the prescribing doctor's name and phone number, so they can be contacted immediately in case of an emergency. The addict does not have the ability to wear an ID bracelet, as there is no doctor to put down, since they have been obtaining their drugs illegally due to their illness-- which is the disease of addiction. In the sad disease of addiction, I feel sorry for the addict in the ED. They are not well-liked in the ED, and at times are even treated as 2nd class citizens. When the nurses and docs see the IV insertion marks, they are angry because this person, although sick, and needing help such as admission to a rehab center, is one that makes it all so hard for the real people that need these types of medications to get them! And what our poor doctors go through to even be able to write the script without fear of FDA reprisal. Any doctor that randomly prescribes pain meds is just simply asking for trouble, and plays a huge part in the world in which the pain patient must live. And in a very negative way. It is like a chain--(that we may be unfortunately caught in somewhere), the docs that are helping the addict by writing the unneeded script, the addict fills and uses them, somewhere along the line the two are put together and caught, (hopefully, and usually only if there is a pattern between a certain doctor and a certain person), yet the doctors with true empathy and care of the patient that suffers from real pain must write Security prescriptions for the Opiates, which the FDA follows closely; we, (the pain patients), must wait exactly 28 days for the script, keeping us from over-using the medicines, and keeping the FDA happy, and from there it repeats itself every month for us pain patients.
It is easy and very interesting to go to the website that licenses anyone who needs a license to work--go to the doctors area, and you may be shocked at the amount of them who are on the list of those who have either lost their license to practice, or have had it suspended, and what is the most surprising to me, is the reason why these docs have gotten into that situation. Yep! Writing unneeded prescriptions, writing a very large amount of pain-medication scripts in a practice of non-pain-related work, such as a Family Practitioner or an Internist; and a variety of other things, including sexual harassment, etc., but for the most part, is has to do with that little pad that many feels makes them a God of some sort. Many doctors do NOT have the ability to write Security prescriptions, they are not able to obtain the pad, as along with being scrutinized in their background, the FDA decides if that doctor works in a chosen field that would require them to write no more than Vicodin, for short-term use. The docs who have the special Security prescription pad have earned it, work in a pain-based area with pain patients, and now have to take a test for EVERY TYPE OF MEDICATION THAT THEY ARE PRESCRIBING. Oh, a waste of time? I am split on that feeling. It keeps the easily-swayed docs out of that group, and keeps in those that are truly serious about prescribing a strong medication for a patient that truly needs it. There is a good reason for both.
So, our lesson tonight: Addiction, Tolerance, and Dependence are words that need to be understood by all pain patients. Remember, the more educated we are, the better we communicate with our doctors, and they are our gateway to a life in the least amount of pain as possible, without being knocked out all day. It is a game of trial and fine-tuning. This does not happen overnight, and changing meds can be one of the hardest attempts we pain patients must make at times, to find that as-close-to-perfect dose of meds. I once changed my main pain medication, to really feel what my days would be like using a new and much more 'easy use' of medication administration to myself. It was truly hell. Yet I wanted to ride it out, give the new one a chance, and see if it would work. I could truly not believe how horrid my pain was. I had no idea it could get so high. It set for me, a new pain scale after feeling that. Now a 9 out of 10 (9/10) on the pain scale is a 7/10 after that experience. I ended going back to my old med, at a different dose, and I was amazed just how well it really did work, until I had gone without it while trying something new. I was NOT HIGH. I was NOT EUPHORIC. I was NOT having fun. It was the worst time pain-wise for me, save for after my double fusion with 2 rib heads drilled out, that I have ever felt. I would not wish that on anyone.
I have said myself, and heard others also, say," I wish I could get a buzz off these meds sometimes." When the pain is so high, and the meds are not working well that day due to who knows why, or we overdid it and don't have enough spoons left, (Hi Christine!); it would truly be nice to feel relaxed and happy at that time. Forget the pain. But we are not addicts. And our pain receptors are using the medications for just that---to block pain. We don't get the buzz that addicts get; their pain receptors are not asking for anything, and they get the medications straight to the pleasure center of the brain. Our pain-filed bodies just don't work that way.
Well, my body is now in pain, as I have been sitting here too long and it is time for my heating pad and answer an important call. I am high off of the fantastic tacos my friend made tonight, and those beans--so creamy....and I can't do one dam thing about my pain right now. Hormones have become my true enemy lately, and for about one week before my period, I get pain levels that have been 9/10 the minute I open my eyes, making little grunting sounds as I make coffee, and then the usual routine, take meds, sit on heating pad, and wait for the effect of both to hopefully take effect. I always get some relief, if even just for an hour; but for the pain to go down to a 7 then up to a 9 again within 4 hours is not what I call relief. But I am not going out searching for anything. I just need to search for the time tomorrow to call my pain doc; for it is med time, appointment time, fill those meds time, and then do it all over again the next month. Addicts may dreamily say how nice that must be. But I'm not a woman with a disease such as addiction who swallows or shoots up drugs to get high. I am a woman with a disease called severe Thoracic Spinal Stenosis, (my spine is being slowly 'crushed'), I am a woman with the disease of bone fragments growing out from the vertebrae and straight into my cord, and I am a woman whose pain causes nothing but empathy from my family that care about me, my friends whose desire is to be able to walk a mile in my shoes so they can understand what it is I feel every day, (I have a feeling they'd stop at a 1/8 mile), and a woman whom my fellow bloggers who do know what it feels like, give me true support and more empathy.
And THAT helps the pain--if even for a moment, if even in my mind, taking the focus onto other things.....
Anything but that pain.
Remember WHO and WHAT you are. We may never get our world or the people in it to understand exactly what it is that we MUST DO to live with everyday pain. And I just don't care anymore about wasting my time in doing that. I am done explaining, cajoling, talking into, about my medications. Let them all think what they want. As I've said before, I surround myself with those who do not judge me or require any type of explanation about my life. Just please don't put the word ADDICT in the same sentence when talking about my pain, and what I have chosen, and need to do so I can have a semblance of an actual life. Please.
Just remember we are pain patients. Not above or below anyone. It is just the hand that we were dealt. I've played enough card games in my day to know this:
I don't care for this hand!! Can I go fish??
BTW, my pain doctor told me yesterday (yes, this has taken me more than one day to write), that the recovery of my hand and arm were known to take 1 centimeter per month to heal. Whaaaaaaat? I asked doc...did you say month??? So we counted out where my numbness starts, how my ability to NOT hold onto things is, and how many centimeters it would take to equal a year.
I've got some time on my hands. My HANDS, get it?? hehe
I hope that the explanation of the words Addiction, Tolerance, and Dependence have been of some help to those pain patients that take strong medications. We do NOT need to explain our choices to anyone!! Just make sure you have someone who you trust to talk to about this issue. To give you a close and honest feedback of how you seem to be handling your meds.
It rarely gets out of hand, but it's good to hear that from someone who truly loves you. Your doctor, the one whom you have a very close and also honest relationship with, should be told everything when it comes to the taking of your medications. They see you for a 1/2 hour every month, every 2 weeks, whatever your schedule is. Thus the reason for that pain journal!! It's hard to remember the last month or 2 and relate it all in a half hour.
Let's take a pro-active stand on taking medications. We have the right, the reason, and the need. Let the addicts get jealous and angry. For they are not us. We are not them. And most of all, let us keep, and STRENGTHEN the bond we have with other people in pain. There is no other group of people than those who feel exactly what we do, to truly care.
Gentle Hugs...<3
Monday, April 13, 2009
Addiction, Tolerance, Dependence #1 *Repost
When those of us with Chronic Pain are prescribed a medication- that we have discussed with our doctor at length, have been informed of all possible side effects, understand what exactly it's function is, why, how, and when to take this medication; and a really great pain doc will let you know exactly what you are getting yourself into, we must all understand the words: Addiction, Dependence, and Tolerance.
These three words are so often used incorrectly, interchangeably-- when they are not; and all three are very misunderstood. When a pain patient needs an opioid or other strong medication to help take some of the pain away, you will run into these words. I don't want you to feel that family, friends, or others that are NOT in your shoes, hear a certain word and try to talk you out of going on a medication that could change your life for the better; so much better. You could have a quality of life again! This decision, of course, is made between you, and your pain specialist. It is you two that talk privately, it is he/she that hears your deepest sorrows, frustrations, and clear descriptions of where the pain is, how long it lasts, what you do that ***exacerbates it, (makes it worse), what helps the pain, and what you feel like on the days that you just don't think you can take it anymore. The others in your circle, including family, friends, co-workers, and those that just think that you must hear their opinion--or the story of Uncle George; certainly mean the best, of course--they care about you; but what do they know of the medications they are so quick to judge--simply because of a WORD??? ONE lonely misunderstood word?
***Receptors***: another medical term that needs to be understood well by pain patients that take medications. This word has so much to do with the entire order of things, in the way that the physiologic part of the body works in conjunction with the medication. Just remember this word and we'll get to that later.
When you first start on an opiate, you will most likely feel the side effects of some euphoria at first, tiredness, constipation, upset stomach, and others. Then... you find yourself after just a while, and I'm speaking a matter of weeks; not feeling one of those side effects: the euphoria. This is where the word receptors comes in. Those of us with pain, have receptors open; waiting for something to fill them, and that is a pain medication. Then those receptors get what they are waiting for, and are filled, like little holes inside you, and when they are blocked, this goes into the whole "Pain Gateway Theory", and the now-filled receptors are able to take that medication and use it to do exactly what they are needed for: To stop the pain. Here is where a very hated, and misused word comes in: Addiction.
The peanut gallery around you hear that you are taking an opioid and immediately say, "No, don't take those, you will get addicted." The latest and most respected studies have shown repeatedly; that those in real pain, that take opioids, that have those pain receptors finally filled; do NOT get addicted. That is an extremely rare occurrence.
Then what is Addiction? This is a state of being. Not a state of feeling. It has nothing to do with pain at all. Addiction is a disease, with a state of mind in which the user is constantly chasing that euphoria. They will do anything to get it: steal, divert, lie, and even begin to think about selling their own things for the money to obtain the drug, or even their own bodies to get it. They will sweet talk those that they know can write a script for them, (possibly a co-dependent in their lives), they will literally become another person, as their only focus is on obtaining the drug, FOR THE HIGH; THE EUPHORIA. In a pain patient, the euphoria is very transient. Why? Back to the Receptors. The medication has a purpose, a place to go, a job to do. In an addict, the receptors that are open are those for euphoria. There is no physiological reason in the body to take these, therefore, all they feel is the high. The #1 sign to look for in Addiction, in the addict, is a change in the person's life--in a negative way. Either it is the person being gone a lot more than usual, as they need the extra time to meet up with those that have the drugs, they start to show signs at work if they are using on the job, or if they are medical personnel, they begin to make a lot of mistakes, especially in charting and in the count of controlled substances, wasting a lot, not accounting for the medication at all, giving too small of a dose and not charting that they threw the rest away, getting a medication from the pharmacy without a doctors order for that patient, and simple, outright stealing, as in the nurse who signed out of the pharmacy a very very strong IV medication for a patient that had been discharged weeks before. In other words, their lives start to fall apart. They do not act like themselves before the addiction behavior began. It is noticed by their significant other, (unless they are also using), the family, friends, and co-workers. You can not be an Addict and not have it come to a point where you hit bottom. I've seen it with both drugs and alcohol in addicts.
So, when the pain patient takes a medication for pain, none of the above needs to happen! We don't need to fight and argue and lie and pretend and shoot up in a bathroom then try to hide being so high you can not speak right or do your job safely. Those of us with pain, are slowly becoming used to a new substance in our body, and that takes us to: Tolerance.
Tolerance is a state in which the body becomes to get used to the amount of medication being prescribed, and we find that the amount we are taking just simply doesn't work anymore, or as well. We become tolerant to that medication, and to have our pain managed, the dose, and/or the dosing frequency, need to be changed to get the same effect. Notice that this has nothing to do with the word addiction. Addiction stands alone, and it is not a word to use in the world of the Chronic Pain patient. There are no equals, no sameness in the two worlds. Pain patients' worlds are already 'messed up' by the pain; but we don't focus only on the medication every second, because we are not addicts, constantly seeking that high. Addiction is a disease. Having Chronic Pain and taking medications prescribed exclusively for that, and monitored very closely by our pain management doctor, is our life, not our disease.
To be continued...............
These three words are so often used incorrectly, interchangeably-- when they are not; and all three are very misunderstood. When a pain patient needs an opioid or other strong medication to help take some of the pain away, you will run into these words. I don't want you to feel that family, friends, or others that are NOT in your shoes, hear a certain word and try to talk you out of going on a medication that could change your life for the better; so much better. You could have a quality of life again! This decision, of course, is made between you, and your pain specialist. It is you two that talk privately, it is he/she that hears your deepest sorrows, frustrations, and clear descriptions of where the pain is, how long it lasts, what you do that ***exacerbates it, (makes it worse), what helps the pain, and what you feel like on the days that you just don't think you can take it anymore. The others in your circle, including family, friends, co-workers, and those that just think that you must hear their opinion--or the story of Uncle George; certainly mean the best, of course--they care about you; but what do they know of the medications they are so quick to judge--simply because of a WORD??? ONE lonely misunderstood word?
***Receptors***: another medical term that needs to be understood well by pain patients that take medications. This word has so much to do with the entire order of things, in the way that the physiologic part of the body works in conjunction with the medication. Just remember this word and we'll get to that later.
When you first start on an opiate, you will most likely feel the side effects of some euphoria at first, tiredness, constipation, upset stomach, and others. Then... you find yourself after just a while, and I'm speaking a matter of weeks; not feeling one of those side effects: the euphoria. This is where the word receptors comes in. Those of us with pain, have receptors open; waiting for something to fill them, and that is a pain medication. Then those receptors get what they are waiting for, and are filled, like little holes inside you, and when they are blocked, this goes into the whole "Pain Gateway Theory", and the now-filled receptors are able to take that medication and use it to do exactly what they are needed for: To stop the pain. Here is where a very hated, and misused word comes in: Addiction.
The peanut gallery around you hear that you are taking an opioid and immediately say, "No, don't take those, you will get addicted." The latest and most respected studies have shown repeatedly; that those in real pain, that take opioids, that have those pain receptors finally filled; do NOT get addicted. That is an extremely rare occurrence.
Then what is Addiction? This is a state of being. Not a state of feeling. It has nothing to do with pain at all. Addiction is a disease, with a state of mind in which the user is constantly chasing that euphoria. They will do anything to get it: steal, divert, lie, and even begin to think about selling their own things for the money to obtain the drug, or even their own bodies to get it. They will sweet talk those that they know can write a script for them, (possibly a co-dependent in their lives), they will literally become another person, as their only focus is on obtaining the drug, FOR THE HIGH; THE EUPHORIA. In a pain patient, the euphoria is very transient. Why? Back to the Receptors. The medication has a purpose, a place to go, a job to do. In an addict, the receptors that are open are those for euphoria. There is no physiological reason in the body to take these, therefore, all they feel is the high. The #1 sign to look for in Addiction, in the addict, is a change in the person's life--in a negative way. Either it is the person being gone a lot more than usual, as they need the extra time to meet up with those that have the drugs, they start to show signs at work if they are using on the job, or if they are medical personnel, they begin to make a lot of mistakes, especially in charting and in the count of controlled substances, wasting a lot, not accounting for the medication at all, giving too small of a dose and not charting that they threw the rest away, getting a medication from the pharmacy without a doctors order for that patient, and simple, outright stealing, as in the nurse who signed out of the pharmacy a very very strong IV medication for a patient that had been discharged weeks before. In other words, their lives start to fall apart. They do not act like themselves before the addiction behavior began. It is noticed by their significant other, (unless they are also using), the family, friends, and co-workers. You can not be an Addict and not have it come to a point where you hit bottom. I've seen it with both drugs and alcohol in addicts.
So, when the pain patient takes a medication for pain, none of the above needs to happen! We don't need to fight and argue and lie and pretend and shoot up in a bathroom then try to hide being so high you can not speak right or do your job safely. Those of us with pain, are slowly becoming used to a new substance in our body, and that takes us to: Tolerance.
Tolerance is a state in which the body becomes to get used to the amount of medication being prescribed, and we find that the amount we are taking just simply doesn't work anymore, or as well. We become tolerant to that medication, and to have our pain managed, the dose, and/or the dosing frequency, need to be changed to get the same effect. Notice that this has nothing to do with the word addiction. Addiction stands alone, and it is not a word to use in the world of the Chronic Pain patient. There are no equals, no sameness in the two worlds. Pain patients' worlds are already 'messed up' by the pain; but we don't focus only on the medication every second, because we are not addicts, constantly seeking that high. Addiction is a disease. Having Chronic Pain and taking medications prescribed exclusively for that, and monitored very closely by our pain management doctor, is our life, not our disease.
To be continued...............
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