Posted by Hermit on June 17, 2006, at 11:37:20
In reply to ‘dependence’ vs ‘addiction’ » Hermit, posted by pseudoname on June 17, 2006, at 8:52:20
> But I’m a little concerned about the phrasing here:
>
> > Yes, you WILL get physically addicted to them
>
> I agree that sweats & other opioid-typical withdrawal
> symptoms are a very likely outcome in varying degrees of
> intensity when abruptly discontinuing longterm use of an
> opioid. I experienced mild sweats for a few days going
> without my low doses of buprenorphine. But it’s not quite
> a foregone conclusion for all people in opioid treatment,
> and it can be managed by gradual dose reduction.I'm not sure we disagree here. By "physically addicted," I mean that your body will experience some physical reaction to not having opiates if it has become used to their presence. That's just the way the body responds, and I have NEVER known anyone to use opiates for any significant amount of time who could stop suddenly and not feel any physical w/d.
Now, that is NOT placing a judgment on these people. Personally, I think the price is worth not having to deal with crippling depression and fatigue, and I'm in no way ashamed of physical addiction. That doesn't mean I can't control my use, nor does it mean I can't taper off when I wish to stop. Those are entirely different topics. :-)
> Also, rather than the word “addiction”, the term currently
> promoted for use in the U.S. related to those withdrawal
> symptoms is “physical dependence”.Yes, that's what most people think of, but addiction actually refers to dependence, whether psychological or physical. (This is according to my own training in chemical dependency counseling.) Again, I don't think there's anything wrong with being dependant on a drug if it improves one's quality of life.
> I think maintaining that distinction can help us combat some
> of the stigma against opioid use. “Being addicted” triggers all
> the worst negative connotations in popular thinking. But
> putting up with physical dependence just means you're
> tough and willing to do what you gotta do.I agree completely. What I think I tend to react to is the amount of people saying, "opiates aren't addictive" when it would help their cause much more (I think) to just admit that there's a physical dependence while still fighting for their right to use these drugs. Otherwise, "They" just focus on the idea that we're all in denial in order to prove some point about how insidious drug addiction is.
Am I making sense?
> Rush Limbaugh aside, addiction does not usually develop in
> those treated with opioids for pain. AFAIK, no opioid-naive
> depressives treated with buprenorphine reported any
> addiction characteristics, even if they had withdrawal
> symptoms.I think we're just differing in semantics here. The way I mean addiction is in referring to any drug that causes w/d, not necessarily a loss of control. What I would rather see is more people educating themselves about what the term actually means and then educating others. (I really do understand your point, however, and it's good to clarify.)
> I don’t mean to criticize. I loved your post, your enthusiasm,
> your insights, and your honesty. I’m just suggesting a little
> clarification on an issue that might be misleading to readers.I completely appreciate your response! I'm glad you gave me a chance to clarify what I meant. To me, addiction doesn't imply a loss of control -- only that the body will grow used to having an opiate in one's system. Withdrawal, if done through tapering the dose, isn't all that bad, and it always ends. :-)
Hermit
poster:Hermit
thread:651514
URL: http://www.dr-bob.org/babble/20060617/msgs/657987.html