SCD & Pain Meds #2: Tolerance, Dependence, and Addiction

Addiction to prescription pain medication is a serious issue in our country. In fact, more people are addicted to prescription pain medication that all other drugs combined excluding marijuana. As parents and patients, this is something we have to be aware of and fight against. Having said that, we need not allow fear of addiction to deprive those in need of pain relief. The key is to be both informed and disciplined. Part of being informed is understanding the differences between tolerance, dependence and addiction. Misconceptions about what each of these mean are held by medical professionals, patients, and the public in general.

Tolerance
Many people believe that individuals regularly taking pain medication will, over time, need more medicine to get the same relief. Based on the research I’ve done, the truth is this is not likely to happen. Building up a tolerance against the medication’s side affects is more typical.

The four main effects of prescription pain killers are: lessoning of pain, drowsiness, nausea, and constipation. Tolerance against drowsiness and nausea is what generally takes place. Lessening of pain and constipation remain the same for most people. This means constipation and pain reduction are controlled, and there is seldom a need to increase the dosage of the medication. [click here for more info.]

Patients who experience a constant level of pain, can have a consistent level of pain relief from the same dose of medication over a long period of time. The need for higher doses of pain killers is due to worsening of pain rather than building up a tolerance to that medication. [click here for more info.]

I personally have found this to be true. I have pretty much been on the same dosage of pain medication for more than ten years. Most of the time I don’t become drowsy or nauseous from my meds. They do what they are meant to, they reduce my pain. Constipation is an issue but, but it’s controlled with senna, a laxative.

Physical Dependence
If you experience withdrawal symptoms when you stop taking a medication, you have a physical dependence on it. This can occur with recreational drugs, prescription pain killers, anti-depressants and other medications. With continuous use of prescription pain medication, physical dependence is normal and to be expected. Understand, physical dependence is NOT the same as addiction. [click here for more info.]

Symptoms of withdrawal may include agitation, insomnia, diarrhea, sweating, and rapid heart beat. On occasion, I have experienced withdrawal symptoms when I have run out of my pain medication or gone twenty-four hours or more without taking my meds. My body most certainly has developed a dependence on my prescription pain killers. I do not, however, have an addiction to them.

Addiction
Physical dependence and tolerance relate to changes in the physical body. Addiction, however, is behavioral; it’s the use of drugs for non-medical reasons; it means a person is craving drugs not for pain relief but for mood altering effects.

Symptoms of psychological dependence can include:
•    Regularly using more of the drug than intended;
•    Difficulty cutting down their intake of the drug;
•    Becoming anxious about not having access to their substance;
•    Loss of interest in activities they once enjoyed;
•    Their abuse is interfering with work, family, or social responsibilities;
•    Lying or acting secretively;
•    Denial of drug use;
•    Forgery of prescriptions;
•    Theft of drugs from other patients or family members;
•    Selling and buying drugs on the street;
•    Using prescribed drugs to get high rather than for medical needs.

Pain medication should not be withheld simply for fear of addiction. Patients who use pain medication for authentic medical needs, in truth, are at LOW risk of becoming addicted; it is in fact extremely rare. [click here for more info.]