Are you "Chemically dependent or "Addicted"?

Two of the most misunderstood terms in taking opiate or opiate-like drugs is Addiction vs. Chemical Dependency. Doctors, especially the News Media and even Chronic Pain patients themselves often misuse the terms. As a Chronic pain patient you have a duty to educate yourself on these things. Its not fair to you and it is certainly not fair to other Chronic Pain patients who are "fighting for our rights." So educate yourself!!

In writing this blog I want to be fair and present the other side. I just wish the "News Media" would do the same. If you take powerful Opiates or Opiods because you live with a level of Chronic Pain that is intolerable, sooner or later you will become chemically dependent on them. This is normal and if at some point you feel you no longer need them, slowely start reducing your dosage until you are completely off of the drug. I would suggest consulting with your Doctor and make sure he is aware of what you are doing. He will probably advise you at what rate you should reduce the medication. If you continue to take them after you no longer need to and make no effort to get off of the pain medications then you have become Addicted. At that point it is time to seek out an Addiction medicine specialist.

When opiates are prescribed by a physician for the treatment of pain and are taken in the prescribed dosage, they are safe and there is little chance of addiction. However, when opiates are abused and taken in excessive doses, addiction can result.

The brain itself produces endorphins that have an important role in the relief or modulation of pain. Sometimes, though, particularly when pain is severe, the brain does not produce enough endorphins to provide pain relief. Fortunately, opiates, such as morphine are very powerful pain relieving medications. When used properly under the care of a physician, opiates can relieve severe pain without causing addiction.

Feelings of pain are produced when specialized nerves are activated by trauma to some part of the body, either through injury or illness. These specialized nerves, which are located throughout the body, carry the pain message to the spinal cord. After reaching the spinal cord, the message is relayed to other neurons, some of which carry it to the brain. Opiates help to relieve pain by acting in both the spinal cord and brain. At the level of the spinal cord, opiates interfere with the transmission of the pain messages between neurons and therefore prevent them from reaching the brain. This blockade of pain messages protects a person from experiencing too much pain. This is known as analgesia.

Opiates also act in the brain to help relieve pain, but the way in which they accomplish this is different than in the spinal cord.

There are several areas in the brain that are involved in interpreting pain messages and in subjective responses to pain. These brain regions are what allow a person to know he or she is experiencing pain and that it is unpleasant. Opiates also act in these brain regions, but they don't block the pain messages themselves. Rather, they change the subjective experience of the pain. This is why a person receiving morphine for pain may say that they still feel the pain but that it doesn't bother them anymore.

Although endorphins are not always adequate to relieve pain, they are very important for survival. If an animal or person is injured and needs to escape a harmful situation, it would be difficult to do so while experiencing severe pain. However, endorphins that are released immediately following an injury can provide enough pain relief to allow escape from a harmful situation. Later, when it is safe, the endorphin levels decrease and intense pain may be felt. This also is important for survival. If the endorphins continued to blunt the pain, it would be easy to ignore an injury and then not seek medical care.

There are several types of opiate receptors, including the delta, mu, and kappa receptors. Each of these three receptors is involved in controlling different brain functions. For example, opiates and endorphins are able to block pain signals by binding to the mu receptor site. The powerful new technology of cloning has enabled scientists to copy the genes that make each of these receptors. This in turn is allowing researchers to conduct laboratory studies to better understand how opiates act in the brain and, more specifically, how opiates interact with each opiate receptor to produce their effects. I just hope it is soon, because personally I hate taking opiods or any medication for that matter. I, like most people in chronic pain just want a life.

Veterinarians receive 3 times more training on pain than doctors and nurses

This is a Canadian survey, but I believe it and it is probably worse in the USA. I also recently learned from a reliable survey that "old people" are the most undertreated for pain, followed by "children", then "women". "Men in the 30 to 45 year old range get the best pain treatment".

"Toronto - A recent survey for the Canadian Pain Society found students in veterinary medicine received an average of 98 hours on pain education, while medical students spent about 16 hours studying the subject.

Among the vets in training polled in the University of Toronto survey, the least amount of specific pain education received was 27 hours, whereas some medical and nursing students admitted they'd received no training on pain at all.

Nursing students spent an average of 31 hours on the subject of pain.

"All the veterinary colleges had way more hours than medicine, nursing, dentistry (and) pharmacy," said lead researcher of the study, Judy Watt-Watson.

She told 680News a stubborn stigma around chronic pain is playing a role. "There are chronic diseases related to pain that we can't take an X-ray of," she said.

One in four Canadians have suffered from chronic pain, according to researchers, who suggest training on the subject should be mandatory, not elective, in more medical schools across the country.

The society said this lack of training is leaving Canadian health care professions inadequately equipped to treat pain-related problems".

Source:Taiwo Lewis
.680 News


I receive a lot of e-mail from people all over the world, especially Canada, New Zealand, UK, and of course here in the USA and it really doesn't matter where, its the same horror stories and the same stigma no matter what the country. It is also a damn disgrace.

I will leave my first bit of education for the medical profession. Here is the stigma. "I am afraid you will become addicted". That statement in itself is wrong. You don't become addicted. Addiction is a behavioral problem, part of it even hereditary, where by people get medication for the high, the euphoric feeling and most have no chronic pain problems.

Chemical dependency is the correct word and is a natural occurrence when people have to take powerful medication for a pro-longed period of time. All you do is start slowly reducing the amount of medication you are taking until you are off of it. As a matter of fact "addiction" and "chemical dependency" take place in two totally different areas of the brain.

How do I know? Because I have gotten off of powerful opiods myself, seven or eight times. If I felt like I needed help getting off of them, I would tell my Doctor and ask him to help me. Why, because like the majority of people in chronic pain, I am not a damn drug addict.

Doctors have opiodphobia

Where do you turn when you walk out of a physicians office after he has just told you that he cannot prescribe anything for your pain because he is afraid you will become addicted? Your pain level is so high that you are wandering if you can make it through the day, yet this so-called medical professional is more worried about addiction than your pain. Something is terribly wrong with this picture. This is what the "chronic pain individual" faces every single day of their life. Opiodphobia!! that is what I call it. It doesn't matter if you have no record of any kind of addiction. It is just like being found guilty before having a trial. If you are a "chronic pain "sufferer you are stigmatized.

I recently changed primary care physicians and started calling around to find a new one. The very first one I called, as I was describing my problems to her and mentioned chronic pain, this was the exact reply. Well I will tell you right now, we don't prescribe "narcotics". This statement only shows the lack of education the medical industry really has on controlling chronic pain. First of all they are not narcotics. This is a law enforcement term. The medical name for these drugs are opiods, opiates or "Schedual II controlled substances approved by the FDA for treatment of severe chronic pain and cancer patients. You don't become addicted. Addiction is a behavorial problem in people, and some of it is even hereditary. People who take street drugs to get high and sometimes people who take drugs for pain and continue after they no longer need them. That is addiction. The correct term is "chemical dependency" which is a normal occurance in anyone who has to take this type of drug. To get off of them when you no longer have to have them, tell your Dr. and he will start slowly lowering your dosage until you are completely rid of them. How do I know all of this. Four back surgeries and multiple intravenous injections, all of which have only made my problems worse and 25 years of sitting up all night reading every piece of medical publication I could find on the internet, watching surgery webcasts, and listening to the surgeons who are not afraid to tell the truth. The person who lives in chronic pain lives the most lonely, painful life in the world.