What do Doctors consider "ADDICTON?

Discussion in 'Fibromyalgia Main Forum' started by ckzim, Mar 2, 2006.

  1. ckzim

    ckzim New Member

    Does anyone know what doctors look for to see if someone is addicted? What I don't understand, (and would never voice it to a doctor,cause that would be a sure sign).....Is there a cure for Fibro, that I would NEVER need a pain medication ever again? That I would then suffer this withdraw thing, (that is so much more horrible than Fibro pain)...because my Fibro is now cured, gone, Zapped out of me?
    How can I suffer withdraw, if I have always got to have some sort of pain med? Are there pain med's that you don't get addicted to??? Doctors here in Michigan are getting horrible about prescribing any kind of pain medication. I've been on them all...Lortab, Vicodin, Hydrodone, Fental patch, ms contin , oxycontin..the only one that works is the Hydrocodone,(Lortab,Vicodin)...for me. One doctor told me its the tylenol that gives the relief in Fibro. I get my liver checked every 3 mths..no problems in 4 yrs.
    Am I some how coming across as a drug addict? I never ask for the pain med, I always ask..."and what can I take for the pain?" When I tell them..I take Ultram and Hydro for break through...I get that cruched up eyebrow look.
    It's been 4 yrs now for me...the last 2 in horrific pain as they don't want me to become addicted! The first years I was prescribed Lortab every 4 hours as needed. Dropped that to Ultram then Lortab for breakthrough, currently I can only have 30 Hydrocodone 10/500 per 90 days. I simply want alittle more than that! I would be happy with one every other day maybe? If I was going to be addicted wouldn't it of been in the first few years with every 4 hours every day? Wouldn't of been with the Fentayl patch of 75mg every 3 days? Or the oxycontin, or the ms contin? I just don't get it?
    I've never had withdrawl ...I don't get high on it, only pain releif. And it's like night and day...I mean I feel almost "normal" when I am able to take the hydrocodone.
    When I was ALLOWED to take more than the 30/90 .. I had a part time singing job, I've had to quit that job, cause I can't bare the pain, with no way out of it.
    So what exactly are these doctors looking for in a addict? I know I look bad, when I go in there, but that bad? My eyes are not glazed over, and drool coming from my mouth, clawing at her ankles give me drugs... for crying out loud! Or is it just they hear the word Fibro...so that means ADDICT! I would gladly take anything else, that gives me relief...so far nothing but the hydro has worked
    ... I'm so exhauseted from the pain...when it doesn't have to be like this. Any pointers? I see yet another doctor at the end of the month, who is currently checking my files for signs of addiction...she stated to me "it's not like you have cancer." She wanted to push the Darvocet...(that doesn't do anything for me), (which by the way isnt Darvocet addicting?) What exactley is this new doc looking for? A certain point that I didn't have Fibro and took pain meds anyway? Or withdrawl symtoms from not taking pain meds? Which has never happen cause I've always been on a pain med. Do they take you off, to see if your addicted? What what do they want?
    Thanks anyone who can help me understand? Or maybe how I can get it through these doctors head...Im not a addict! I'm not looking to score my next deal...and how do I have withdrawl if I am always going to have Fibro pain, for the rest of my life, or until the cure comes!
    Kathy
  2. Rosiebud

    Rosiebud New Member

    that most medical practitioners know realise that if someone is taking a strong med, narcotics, for pain then they do not get addicted.

    If you were to take the same med without pain then there is a high risk of addiction.

    I now get narcotic pain meds from my doctor whereas a few years ago he wouldnt even consider it.

    love
    Rosie
  3. leubie

    leubie New Member

    Kathy, I am sorry for all your troubles. I too have fibro--and know just how horrible it abd the doctors can be. Are you seeing a pain specialists????--If not---have this Doctor refer you to one. I go to a neurologists/ pain doctor and that has really helped me. My Doctor told me that he does not like to prescribe hydrocodienne for long term use because it only last 4-6 hr BUT HE WILL FOR BREAKTHROUGH. Inform this Doctor you are an adult and would please like to be referred to a pain specialist. I hope they will listen to you. Let us know--take care--LOVE TO ALL ---LAURA
  4. mme_curie68

    mme_curie68 New Member

    Hi Kathy -

    Any opioid narcotic can make you "addicted" in that if you have been taking it for pain and then you don't take it you can experience withdrawal symptoms physically (receptors for the narcotic are formed in your body like little locks - don't put the "key" or drug in the lock and there are genuine physical ramifications until the receptors "die off") and psychologically. However, that said, when a person is in chronic pain without adequate pain control the pain can get WORSE in a vicious cycle. Ideally, adequate pain management makes you comfortable and functional without being "buzzed" or "high".

    Any doc that won't help you control your pain symptoms because he is afraid of the liability of "drug-seeking behavior", i.e. - you're faking it just to get pain meds. so you can be buzzed - is a sadist with their own best interests and not the best interest of the patient in mind as far as I am concerned.

    NO ONE, EVER, should have to suffer in pain without help. The key is to find the right combination of pain control that blocks the pain chemicals from being produced so you don't get into a vicious cycle of pain producing more pain. Sometimes narcotics are what is necessary to do the job. Controlling the inflammation that produces the pain is what should help longer term.

    Tylenol DOES NOTHING to eliminate pain chemicals. It increases your tolerance for pain without doing anything to block neurotransmission of prostaglandins. Ibuprofen and other non-steroidal antiinflammatories actually block transmission of prostaglandins.

    This is where a pain clinic can help you best. Why? Because the docs are all there to TREAT chronic pain - not to give you a pat on the back and a lot of grief as to what you "need" and "don't need". They want to treat you and help you get control of the pain. Often also they are hooked up with "non-Western" "alternative" treatment modalities like acupuncture, biofeedback, etc. that can be used in conjunction with Western-style medicine.

    My advice is to find a more compassionate doctor and get a referral to the specialists who want to help you and find the best pain control that works for you, WHATEVER that may be.

    Best Wishes
    Madam Curie

  5. dragon06

    dragon06 New Member

    Well I have not been in the US long enough to comment on many of the doctors here but my own. I am currently taking Vicodin for pain and have been for 1.5 years, I get 30 pills for 30 days. I also have Darvocet 30/30 and take other medications. My doc has never said she thought I was addicted but I know a lot of doctors do. I do medical transcription and I can't tell you how many files I type that say "Patient shows drug seekign behaviour" for fibro patients.
    I know it is a little more lenient in Canada. My mother has had this illness for 21 years and has been on pain meds for most of them.
    Do people need to take pills for the pain? YES!
    Will the pain suddenly leave? Probably not (even tho we would love that)
    Does needing to take pain pills every day because you have chronic pain mean you are addicted? Absolutely not!
    If taking pain pills meant that some day I might have to go through withdrawl because they found a cure would I still take them? Absolutely!

    I think you truly need to find a fibro friendly doctor. Type Fibromyalgia Advocate into google. There you will find some information for looking up fibro doctors in the US.

    I don't care what the doctors say, if you take meds to relieve pain so you can at some point feel semi-human again then you are not an addict. You are not abusing the drug, you are using it for it's intended use.
    [This Message was Edited on 03/03/2006]
  6. deb06

    deb06 New Member

    Go see another doctor. Its ridiculous that this is all they will give you. I am on the minimum I need at 40mg oxycodone twice daily and 3 hydrocordone daily as needed which I need. Go to a rhuemotologist or a pain clinic and get some help. Love, Deb
  7. Mikie

    Mikie Moderator

    That's what I call the lack of knowledge and fear which prevails, even in educated medical circles. First, a very, very small percent of those with chronic pain become psychologically addicted to pain meds. That small percent will display drug seeking behavior which is relatively easy to spot. They will lie, cheat, and steal to get their next high.

    A person with chronic pain does not get high off her meds. In fact, most of us don't like taking them because of the side effects. The drugs are busy helping us with our pain and don't hit that "Pleasure Center" of the brain as they do in addicts. This isn't to say that someone can't get psychologically addicted who is taking drugs for pain, but it really is a small percent.

    What those on meds for chronic pain do get is physical dependence and/or tolerance. Dependence just means that one's body is dependent on the drug and will rebound if the meds are withdrawn. Tolerance is a little different. Our bodies produce useful pain to let us know something is wrong so we won't bleed to death if we are cut or won't try to walk on a broken leg. The kind of pain we suffer serves no such purpose. It is amplified in our nervious system by something called, Substance P. It can be found in our spinal chords. But, I digress...

    Since the body thinks something is wrong and we "need" the pain, it will produce more pain when pain meds are taken. It's like our bodies are shouting at us to pay attention to our pain. So, we take a little more of the pain meds to shut our bodies up. Then, the body "shouts" louder with even more pain. You can see where this is going. People who have been on pain meds for years are often at doses which could kill someone else.

    Not all docs know this basic info and then there is the FDA breathing down their necks. Yes, Big Brother is watching carefully those docs who prescribe opiods. The U.S. war on drugs has been a miserable failure but the war on docs and pain patients is being fought so that people think the govt. is actually doing something about drug use.

    Most of us have had a hard time, at some point, getting pain relief and yet, it is possible to buy most anything off the street if one knows how. Rounding up all those street dealers is a lot of work. It's easier to go after docs and their patients, especially when prominent people, like Rush Limbaugh, make the news. Docs who are overprescribing pain meds and helping their addicted patients need to be stopped but it shouldn't keep the rest of us from obtaining the drugs we are legally entitled to and need.

    That said, I can't not mention the Guai treatment. I was on Morphine for my pain and in bed most of the time five years ago. I happened to find a good pain management specialist who understood our kind of pain. I didn't want to become dependent on the Morphine and I knew that eventually, I would need to increase my dose. That's when I heard about the Guai here and went to Dr. St. Amand's website. I bought the book, "What Your Doctor May Not Tell You About Fibromyalgia," and after reading it thoroughly and becoming sal free (explained in the book), I started the treatment.

    It was about a year before I wasn't taking the Morphine at least once in a while, but I didn't need it nearly as often. My Fibro Fog cleared up almost immediately and I actually had some good days early on. I now seldom take anything stronger than OTC pain meds unless I get injured. Those who know me know that I also have CFIDS, which for me, has been much more difficult to treat. Still, not having to worry about the symptoms of FMS had freed me up to proceed to my treatments which are helping me to heal the CFIDS.

    The Guai treatment is about the only treatment which offers the possibility of reversing the symptoms of FMS. I believe it works for additional reasons than those theorized by Dr. St. Amand, but it doesn't really matter to me how it works. It has been a God send. I encourage anyone who has to use opiods for FMS pain to check it out.

    Love, Mikie
  8. obrnlc

    obrnlc New Member

    hi Kathy, no you are not an addict, and the doctors that think so are ignorant of fibro, pain management, and the Hippocratic oath! I was on a combo of Hydrocodone 30mg/dextromephorphan 20 mg (Contained no tylenol, so scratch that theory) and had to go to a new doc. who said she would never prescribe hydrocodone, but gave me MS contin instead (does very little for the pain!) as far as narcotics go, hydrocodone (ingredient in vicodin, lortab, etc.) is the least of the "schedule" drugs, and seems to be the one most effective for most fibro people. The fact that a combo drug has no tylenol makes it far safer on the liver, and i have even heard mention of darvon/darvocet being investigated by the food/drug people for safety issues (also contains alot of tylenol) As far as side effects and liver toxicity go, Tylenol, follwed by motrins, and other OTC anti inflammatories are the most hazardous drugs out there for pain relief!
    as far as addiction--you are probably physically DEPENDENT, however you don't take very much, so not sure, (i was on the 30/20 combo 3 times a day) but you may go through a withdrawal process. this doesn't mean you are an addict, just physically dependent. An addict craves the drugs for the feeling of being "high" and we need it just to get a few hours of normal function in!
    The withdrawal sypmtoms that i had, worse for duragesic, less for hydrocodone, but still very present:
    weakness, overwhelming sleepiness, pain and muscle tension amplified severely for the first week but easier to take afterwards, diarrha--frequent!, unable to eat or drink much for a week or so (dropped 15# in a week w/duragesic) severe anxiety, sneezing alot--always in a series of 3, isn't that weird!,
    Once i called a detox center to get advice and the nurse talked to me like a junkie--she said" the vic's and the perc's are just as hard to come off....."
    Now i have NEVER referred to my meds with shortened little "pet names" and she really ticked me off by treating me like a junkie!
    One thing that helped alot was my hot tub (if necessary-come detox at my house!) and my husband trying to keep me sane and hydrated. What almost killed me--my pain doc decided to prescribe clonidine for withdrawals, apparently it works in detox centers, but (and as an RN i am ashamed to admit this!) I didn't realize it was a BLOOD PRESSURE med, i thought it was the generic name for KLONOPIN, a antispasm type, and i started to get severe heart symptoms and since fibro people have notoriously low blood pressures to begin with (many do) this dropped me to a level that did almost kill me, til i talked to a coworker who looked it up and found out what the problem was. so beware of that, but i do hope you can find a decent doctor that won't do this to you, withdrawal, i mean, but will treat you with the respect that you deserve, there is such a huge difference between we chronic pain patients and an "addict"! Good luck--L
  9. ckzim

    ckzim New Member

    for all the replys...there is so much info in these posts I have to re read them carefully make notes, and get this in my brain! You all are very informative,supportive and welllll just so wonderfully GREAT! Now that I've done my homework with you guys, I will be more prepared, and able to do what I got to do.
    I've got 20 more days to go, befoe I see this "investigating" doctor again, and I don't know how I am going to make it through? The Ultram is barely taking the edge off,along with making me so groggy. I have to save the 3Vics I got left for doctor appts etc..the Elavil is doing nothing but making me sick.
    The Zanaflex is helping with the muscles, (nice bruises I got there)
    What's got me sooo confused is this new doctor is a MD too!
    What the heck???
    So now do I call her, and tell her I need a appt sooner, it will be 4 weeks since I last seen her. Or do I call the orginal MD...who prescribed the lortab? Even though he referred me to this other MD?
    I'm stuck!
    Just sit it out for 20 more days, see if she will prescribe the Lortab? If she doesn't...then I sit another who knows how long, before I go to the next doctor?
    Is any of this making sense?
    If I ask for a referral to a pain speclist, from either of these, does that make me look like a addict?
    When I asked this "investagating" doctor what do I do when I run out of the lortab I had 5 left since NOV of last year , and the pain is so great? She replied...hopefully you don't......... I just looked at her.ok????? so that kind of tells me here stance on it doesn't it?
    I just want out of this pain, I don't care what they have to give me...knock me out, bury me...I don't care...just get me out of the pain!
    Ok...enough crying...thanks again everyone!
    HUGS HUGS HUGS to all!
    Kathy

  10. karatelady52

    karatelady52 New Member

    Kathy,

    Don't think that all pain specialists believe in narcotic pain meds.

    I went to a pain specialist for 6 years for what I thought was FM/CFS (but since then found out its lyme) and all she would give me was Ultracet. They didn't work very well after the second year.

    After coming to this board I asked her about Oxycontin. She just about burst a blood vessel. She said, "Oh my God, NO!!!

    She also told me it was a big lie that people in pain don't get addicted to drugs.

    Now that I've found the Fibromyalgia and Fatigue Centers, I'm on Oxycodone 10 mgs. and take them every 3 hours when I'm in pain or herxing. They didn't blink an eye and even asked if I wanted something for pain.

    That was my experience with a pain specialist. She didn't test for viruses/lyme plus she didn't give me pain meds that helped. I wasted 6 years there instead of finding out the cause, using pain meds as needed and working towards getting well.

    I sure hope you can find a doctor who will help you and give you some pain relief. Its a tricky situation because you can't call and ask if they give good pain meds -- big red flags go up.

    Sandy
  11. obrnlc

    obrnlc New Member

    hi kathy, i'm sorry that you are in so much pain, with 3 vicodins left, that is a scary situation. try to call the primary that referred you for something in the meantime, but DO NOT save your meds for dr. visits. they need to see you at your worst, not your best! also, ask for some PT, specifically pool (warm water) therapy, and the PT notes will be very valuable in your quest for relief, as they will see you for an extended period of time and see how you really are, not just for 10 min. in an office while medicated.. I've found that i get a much better evaluation from a physical therapist, rather than an actual dr. PLEASE don't take meds before you go in there, then they don't see how it really affects you! Good luck--L
  12. Greenbean7

    Greenbean7 New Member

    Hi Kathy, sorry you are having so much pain!

    One thing I noticed is if I refer to my pain medication as pain medication instead of pain pills other people don't react quite as negatively. I was glad to see you use this term instead of pain pills!

    I take hydracodone (sp) everyday. I have one rx for 500 mg which I can take and still drive, and an rx for 750 mg which I usually take when I get to work as that gives me 4 hours before I have to drive again.

    Each time I go to the doctor I bring up the subject of pain meds. I don't wait for him to do it. I want to verify with him EVERY TIME I see him that he doesn't think I take too much.

    He has explained to me several times (I am blessed with a wonderful GP) that I am dependant on the medication to function much the same way that a diabetic needs insilon (man, I cannot spell today!).

    There is a vast difference between dependance and addiction. I take these meds for pain. I do not take the meds if I am not in pain (of course pain is relative, if it is bearable I won't take the med). I do not take the meds to get high, that would make them pain pills, not medication.

    I hope that helps. This is an area a lot of us struggle with and I think it is good to go over it from time to time, especially for newbies.

    Sorry I didn't have anything funny to say this morning, plain to see where my pain is today!!

    Hugzz,
    Greenbean

    Stop and smell the puppies!
  13. marilynb

    marilynb New Member

    I can So relate to everything said here. I am so very tired of this vicsous cycle. I am in pain every day. I take 4-5 Norco 10/325 EVERY day, along with Robaxin 500mg(muscle relaxant) 3 a day. I take 1 of each, every morning just so I can start my day. Then 3-4 hours later, the pain starts getting worse & it's time for another 1. I have tried not taking them, but just can't. Since there is a pharmacist & a pharmacy tech in the family, they are really worried about my long term use & having to take it every day. They have told me I really need to get off all the narcotics. So not only do I have to deal with the pain & the drugs EVERY day, but I have them always on me about it. What else can I do?? I have tried other things that weren't narcotic & nothing worked.
    I try to tolerate the pain & not take the meds, but I always give up & reach for them as I start to cry. I feel like I don't run my life anymore, the pain & meds do!!
    I have mentioned to my pain Dr's, nurse practicioner about being afraid of getting addicted & she said I am not addicted, but my body is dependent on them. She said there was a difference & I am taking them for a legitament reason. I don't know what to do! If I do manage to stop taking them, then what?? I am back to square 1 & have to start all over, trying to find something that works. I think the only thing I have not tried is accupunture. Has anyone tried this? Does it work? How do I stop taking the meds I'm on? Please help!
    Thanks,
    Marilyn
  14. Mikie

    Mikie Moderator

    Have you looked into the Guaifenesin? It is not a quick fix but for many of us, it has given us a life without opiods. It is well worth looking into.

    I've decided to post under a separate thread. There are so many new members that it may be time for me to post again.

    Love, Mikie
    [This Message was Edited on 03/03/2006]
  15. ckzim

    ckzim New Member

    Would anyone mind if I print all this good info up? It's kind of hard, to remember it all, and it's all such good stuff!
    KarateLady,obrnick, greenbean7 Marily and Mikie, you really help me feel better with all your support, and helping me know I am not alone in this up heavel...(I can't spell either) lol...now it's getting up the nerve to speak this to my doc...I have a feeling she will just kick me to the curb! Oh well...better now than later!
    Hugs to you all!
    KathyZ
  16. marilynb

    marilynb New Member

    yes I did get that book you mentioned about the Guaifenasen treatment. I haven't figured it all out yet but I was telling my husband I wanted to give it a try.
    I just went for an 1 & 1/2 hour massage, & I feel pretty good right now. She just did light massage & some reflexology with my hands & feet. I told her I would not be able to stand any deep tissue massaging.
    Thanks for the info & for caring.
    Marilyn
  17. jaime13

    jaime13 New Member

    According to my Dr pain patients who are not abusing there pain meds are not addicts, he says a addict is someone who abuses drugs,like a junkie who would do anything for his next fix. He says someone who is responsibly taking there pain meds my built up a tolerance, but rarely becomes psychologically addicted. He claims that people like Rush Lindberg or other Holllywood types give much needed pain meds a bad rep. and make it difficult for people who really need to get them. The FDA comes down hard on well intending Drs. making them all but jump through hoops to get the drugs to people in pain, for many Drs. its plain not worth it and others buy into this Hollywood glamor oof the abuse of drugs and anyone who even ask for pain meds is a potenial junkie. Many Drs. don't even believe in the pain of fibromyalgia and the safe and effected use of opiates in treatment along with other drug protocals.
    To get off pain meds your Dr. can safely wean you off reducing your amount every 2 weeks. Going off pain meds does not have to be painful or tramatic.Rather with the help off a caring Dr. it can be easy and liberating to be out of pain and off the meds.
    jaime
  18. marw

    marw New Member

    ...not as worried about addiction as he is about liver damage with the hydrocodone 5/500. It works well for me. Been taking it every 4 hours (4-6 times a day) for almost a year. What happens is that everytime I see him we have this "discussion" where he doesn't want ot refill it! I am O.K. with trying another opiate or this one at a different level of tylenol....Lortab, for example....but he doesn't seem to want to do that. He once tried Fentanyl patches, but even the lowest one caused me to OD on it and end up at the ER. I can't take high doses of anything.

    I guess I am just saying I sympathize with you, because I worry about how to get my pain medication. I absolutely could not stand the pain if I didn't have it. This is NOT drug seeking behavior...it is just pain. Other doctors have outright accused me of drug-seeking behavior, so I just walk out if this happens. I am fortunate so far with my PCP that he is interested in Fibro and knows a lot about it. He has a lot of sympathy for us, also. He did try the anti-depresssents with me, and other "nerve" drugs, but I could not take any of them.

    In the past when I have wanted to go off a drug (I used to take Valium, and have started back now sometimes for the muscle relaxant effect at night), I just start cutting down on the amount. I break the pills in half. Then I move them further apart. I've never had any withdrawal symptoms when I do it like that. It was according to my doc's protocol and it worked fine.

    Many docs are afraid of the DEA and are afraid to prescribe pain Meds. There was an good article in AARP in Septempber issue about this. Although directed towards seniors, it applies to anyone trying to control pain in their bodies. I will try to find this and post it later as a separate post.

    No one wants more than Fibro patients for this disease (and yes, I know it is a symdrome, but I still call it a disease....it HURts SO MUCH!!) to be cured! Oh, to never have this pain again! It ruined my life as it has so many others. WE have to do as much as we can to stay functional, and that surely does include our pain meds!

    Margaret
  19. ckzim

    ckzim New Member

    I was relieved to read wht you said...
    " worry about how to get my pain medication. I absolutely could not stand the pain if I didn't have it. This is NOT drug seeking behavior...it is just pain"
    Cause that is how I feel exactley!
    Thanks for getting that out there, my mind couldn't do it at the time(fog)
    Kathy
  20. Mikie

    Mikie Moderator

    Let us know if we can help with the Guai or if you have any questions. Good luck.

    Love, Mikie

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