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I’m Not Addicted, Are You?

What’s the difference between addiction, tolerance, and dependence?

By Julie L HodgesPublished 3 years ago 3 min read
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Image by Myriams-Fotos from Pixabay

As Americans, we’ve all likely seen the ad that says, “This is your brain, this is your brain on drugs.” The war on drugs has shaped our impressions of what taking drugs and medications mean, and a stereotypical image of what an addict is. It doesn’t help that the words “dependent” and “addiction” have been so often used interchangeably, making many people think dependent people are addicts. That isn’t true. The two words have different meanings.

Most of us don’t have a relationship with illicit drugs, but if you are a chronic pain patient, you likely take medications, like opioids, on which you will become dependent and tolerant, and possibly addicted. The problem is we need drugs, like opioids, in order to survive and be productive and happy. If I didn’t take my pain medications, I wouldn’t be able to sit here typing this article. I would be lying in bed crying and wishing I were dead. I know there is no way to cure the illnesses I have, Fibromyalgia, Arthritis, Degenerative Disc Disease, etc. I would pray to die and, after a long time, I would probably make sure I died. Chronic pain is dangerous for a person’s mental health.

It’s sad we live in a world where pain medication is almost shameful to take. You can see it in the judgmental faces of some pharmacy and clinic employees. We are labeled as drug seekers. We are seen as no different from the junkie on the street. Doctors are limited and punished for doing their jobs. Chronic pain patients are stuck in the crossfire and we suffer because of the illegal actions of others. In reality, my pain medication is no less important for me to take as diabetes medicine would be for a diabetic.

I take my medication properly, even if I still hurt. I’m not addicted. You see, what you may think of as addicted is actually called dependent. The two are different. Addiction is a psychological state. Dependence is a physical state. They are often, incorrectly, used interchangeably. Tolerance is a physical state which can play a part in addiction and dependence.

Dependence is when the body adapts to the presence of a drug in such a way that if you stop taking it there will be an adverse reaction known as withdrawal. Withdrawal symptoms for either opioids or antidepressants are extremely uncomfortable. I have felt both and I don’t want to feel either again!

Tolerance is a physical condition whereby the consumption of a substance/drug causes the body to need more over time to get the same benefit, think opioids, alcohol, and caffeine.

Addiction refers to an uncontrollable, psychological need to seek out a specific type of drug, substance, or activity. You can be addicted to pretty much anything. Some addictions have nothing to do with drugs. You can be addicted to chocolate, food, caffeine, gambling, television, exercise, sex, biting your fingernails, work, plastic surgery. Name your poison.

Many chronic pain patients are concerned about becoming addicted to their medication. But people with chronic pain are unlikely to use their pain medication incorrectly. According to Gary Reisfield, MD, assistant professor, University of Florida College of Medicine, in Gainesville, Florida, a 2008 study, which compiled previous research, of people using opioid medication for chronic pain not related to cancer found that only about 3% ever become addicted or abuse their medication. Less than 1% of these patients who never abused drugs or been addicted ever become addicted or abuse their opioid medication.

One major reason chronic pain patients on opioids do not get addicted or abuse their medication is because they take their medication as their doctor has prescribed it. I have been taking an opioid medication for my chronic pain since 2004. Never have I taken my medication incorrectly. If you are tempted to do that, ask yourself if it is purely because the medication is not doing enough to relieve your pain. And know that it’s likely no medication will get rid of your pain 100%. You will have to accept that reality and handle the remainder of your pain with other pain relief methods, such as meditation, gentle movement, and keeping a journal.

I hope I’ve answered some of the questions I’ve been asked about using opioids for chronic pain and have relieved some of the fears. If you have further questions, please reach out to me at [email protected].

If you enjoy my work on Vocal, please consider tipping me or buying me a cup of coffee at https://ko-fi.com/thepainguru. Thank you for your kind and generous support.

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About the Creator

Julie L Hodges

Julie, aka The Pain Guru, lives with chronic pain in Nevada, teaches yoga/meditation, reads and writes every day. She loves her life with a husband and dogs, a paranormal team, going places in their RV, and having lots of outdoor fun.

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