It’s a lie! You aren’t Addicted.

The media, our friends, our family, even our doctors tell us that long term use of opioid pain killers causes addiction.  I bet there isn’t a single person with chronic pain who hasn’t been treated like some twitchy drug-seeking addict by their doctors, friends and family.  Well I’m here to tell you–they are wrong!  This is actually a widespread misunderstanding of the difference between physical dependence and addiction.  This difference is vital.  Here are the definitions.

These Don't Own You!

These Don’t Own You!

Addiction is a neurobiological disease.  Your genetics, your environment, and how you interact with it are all factors in addiction.  People who are addicted tend to have poor control over the drug use.  They crave the drug for the high not the pain relief.  And the real telltale is when your drug use continues even when it starts to hurt you physically, mentally, and socially

Addiction is a totally different animal than physical dependence.

Addiction is a totally different animal than physical dependence.

Now poor control over drug use does not refer to the fact that as time goes by you need more medication in order to get the same pain relief.  That is caused by your body building up a tolerance, which is a completely natural reaction to taking many medications long term not just pain meds.  Also these meds do interfere with you physically, mentally, and socially by causing fatigue, loss of concentration, and lethargy.  These are side effects.  Addiction, on the other hand, means you are putting getting the drugs and being high above other normal priorities such as your health, your mental state, and your relationships.

So I sold you wedding ring for another high.  I don't see why you are so upset!

So I sold your wedding ring for another high. I don’t see why you are so upset!

Physical dependence is where the body adapts to the medication and builds a tolerance so when the medication is stopped cold or reduced too quickly you will experience withdrawal symptoms.  Physical dependence doesn’t just occur with opioids either, many other medications build a physical dependence including antidepressants, beta blockers, corticosteroids, anti-seizure medications etc.

Tolerance looks like addiction but it is not.

Tolerance looks like addiction but it is not.

While most chronic pain patients who take opioids long term do become physically dependent, very few will ever become addicted. The small handful that do develop a problem most often are genetically predisposed to addiction. In a review of 24,000 patients who were medically prescribed opioids, only seven could be found who were addicted.  The long and short of all this is that addiction is the exception rather than the rule.

What does all this mean?  It means that all the hype isn’t true.  If your pain were to disappear tomorrow you may have to reduce you dosage slowly, but you won’t have any trouble giving them up.  You just have to give your body time to adjust to the new reality.  So the next time someone lectures you about the dangers of addiction to pain medication you have the option of setting them straight or silently knowing that they are wrong and you are fine.  Now you can let go of any guilt or anxiety about your “addiction” to pain killers because it probably doesn’t even exist.  I know I was relieved when I realized that while my body was dependent I was not addicted.  There would be no rehab in my future and I could stop worrying about my future status as the drug addicted disaster everyone told me I was bound to become.  So can you.

Phew, this is not my future!

Phew, this is not my future!




About leitis23

I'm an adventure, living life to the fullest, and doing stupid things enthusiast, whose life took a serious left turn into chronic invisible illness. My saga of adventures in the world and in medicine never fail to keep life interesting.
This entry was posted in Chronic Illness, Chronic Pain, conditions and diseases, coping, Doctors, family, fibromyalgia, health, helping, humor, ilness, invisible illness, language, Medicine, pain management, practicing medicine and tagged , , , , , , , , , , . Bookmark the permalink.

11 Responses to It’s a lie! You aren’t Addicted.

  1. mxaxm says:

    Thank you!!!!

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    • leitis23 says:

      You are most welcome, living with chronic pain is hard enough, thinking that you are an addict because you body is doing what it naturally does is unnecessary. It was a load off my shoulders when I learned the difference. Please feel free to share.

  2. bghvsl says:

    Thank you so much for this posting. I am on Prednisone, anti-depressants, Oxycoset, all for Asthma, arthritis, panic attacks, depression, etc. I can’t take anti-inflammatories because I’m allergic to them, but the Tylenol with Codeine & exrta-strength were just not working any more. I have found when I’m on the high doses (for me) of Prednisone (50mg), my arthritis is much more under control and I can back off the Oxycoset, but I was still feeling guilty that they were starting to control me instead of the other way around. SO thank you for this. It really put my mind at rest. I wish all the doctors agreed, instead of giving me a hard time whenever I say they aren’t strong enough anymore. I’m only 67 but when I can’t walk 5 minutes without feeling like I’m walking on my knees there really has to be a problem. Why is it always so hard to get doctors to believe you know your body better than they do. They don’t put up with the pain every minute of every day!!!

    • leitis23 says:

      You are welcome, thanks for reading. Before I learned this I was so afraid of being addicted to my meds that I under treated my pain. It scares you if you don’t know the difference and that is just one more stress we absolutely don’t need. I don’t know why it is so hard to get doctors to believe you. My guess is that chronic pain just started being recognized as a, I don’t know, disease I guess. So the medical community doesn’t really know what to do, they aren’t trained for pain management unless that is their specialty. Basically, right now, it’s a mess and we are suffering for it. There are still doctors out there that believe fibromyalgia isn’t a valid diagnosis. Also, we all know doctors are rushed and they are trying to fix you in their allotted 15 minutes and it is human nature to go with the simplest explaination. Which unfortunately in the case of severe chronic pain for no clear reason the simplest explaination is that it is all in your head, or your exagerating, or (the really annoying one) just seeking drugs. That is my theory anyhow, intellectually. Doesn’t make me feel much better when I’m dismissed by yet another doctor as drug addled addict looking for another sucker of a doctor. If my pain went away you bet I would be off those drugs as fast as possible.

  3. Wow didn’t know there was a difference..

    • leitis23 says:

      Most people don’t and I don’t know why but the doctors don’t tend to explain it. I have a wonderful doctor who explains everything to me and that one pretty much blew my mind. Thanks for reading.

  4. I really should introduce myself. I am new to blogging some I don’t know all the ins & outs yet. My name is Sylvia Tewsley. I live in Campbellford, Ontario, Canada. I have been in & out of hospitals since 1997 for more problems than I can count and for many years I have felt helpless being under a myriad of drugs – especially since I am allergic to many of them and I never know when I will add another to the list. Even my son “jokingly” calls me a druggie – but it still hurts. He refuses to take any meds at all unless he has no choice – I used to be the same way. I want to say, just you wait – but I don’t want to put that sword over his head. He has arthritis in his knees, but he says they can’t help because a) they don’t believe him – he is only 33 and b) he doesn’t want to end up dependent on drugs too. What can I say. I love your cover photo because that is how I feel most days – sun all around and beautiful scenery but I’m in the shade, alone. Thank you for giving me a glimmer of the sun!

    • leitis23 says:

      Sylvia, welcoming to the land of blogging. I’m actually relatively new to it too. I start this in August and it has been quite an adventure. For the medical conditions that doctors don’t fully understand instead of treating the disease (usually because they don’t know what it is) they treat the symptoms. This leads to a speedy fall down the rabbit hole of having a medication for everything, and then you even start taking meds to treat the side effects of other meds. Before you know it you are taking handfuls of pills multiple times a day. Doctors don’t understand chronic pain, which blows back on us in the form of an overflowing medicine cabinet. I just wish in the course of all this prescribing that doctors would take a little time and explain the difference between physical dependence and addiction. Maybe you should have your son read this article. You might also find an article I wrote called “6 Things About Chronic Pain You Didn’t Know You Knew” It seems to have resonated with a lot of people. Its in my September archives. Thanks for reading and always feel free to share, especially with your friends and family. I’m trying to bridge a gap between those in chronic pain and their healthy loved ones. When I was at my worst I wished someone could explain my experience. So now I’m trying to do that for others.

  5. steven1111 says:

    I’ve been taking pure opiates for over a dozen years now, from oxycodone to methadone, from morphine to dilaudid and more besides. I’ve Never become addicted and I still take the same dose I’ve been taking for many years. I hate the stigma that attaches to taking opiates. They’re a lifesaver for me I know. I’d spend all day in bed without them. Education is sorely needed and your post helps with that. Thanks for writing this.

  6. Great post! I really wish this was common knowledge. So many people who could really benefit from opioids refuse to take them, because of this (false) narrative we have in both medicine and popular culture where anyone who takes prescription painkillers is automatically labeled an “addict.”

  7. Kim Baynes says:

    Thank you so much. I always knew there was a logical way to explain how I have been able to remain on an opiate for chronic pain relief, for fifteen years!
    My dose has remained relatively the same and although my daily dose is small, without it my pain is huge.
    I have watched people I love become addicted to opiates to the point of almost losing everything. I have defended myself to these people when they call me an addict as well, but never quite so logically. And you are so right about the negative stigma attached to any opiate based pain medication.
    Two years ago I was hospitalized due to a ruptured appendix, which happened while I waited for six hours in the Emergency Department of the Hospital.
    Because I am very open about the medications I take daily, when asked, I was treated like someone who was in Emergency for more pain medication..
    Because of the obvious discrimination, I almost died and was hospitalized for three weeks, hooked to a intravenous of antibiotics for most of my stay.
    One of the physicians who examined me, after the first week, actually blamed my pain relief medication for the reason that my appendix ruptured by saying something to the effect of, narcotic users don’t know when there is something wrong, because they can’t feel it!
    I told him if he pressed on my side one more time, he’d need a pain killer, and complimented him on his charismatic bedside manner.
    This is just one small example of the derogatory comments I have listened to over the past few years in regards to my use of opiate based pain medication, and the complete ignorance and lack of empathy I have encountered, especially among the professionals entrusted with our well being.

    Because of this I have to thank you for such an insightful and informative blog.
    You have enabled me to put into words that my medication is an essential component to my quality of life, as well as they reason I am able to get up every morning and walk my dogs before I go to work and remain a contributing member of society.

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