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  • TDS Moderators: AlphaMethylPhenyl | paranoid android

do I have an opiate addiction/dependence?

J

jjj678

Greenlighter
Joined
Dec 22, 2013
Messages
11
I have been a chronic pain patient for nearly 5 years now I have been on some heavy pain killers from tramadol all of the way up to morphine and a couple of times fentanyl when I had surgery. I was mainly on oxy, vicodin, and a buprenorphine patch the first 2 years, then after my last surgery transitioned over to tylenol 3/4. I did have the classical signs of mild-moderate addiction and dependance when I was on the heavier meds but now that I am on codeine I don't really think I have an issue. I get 60 tabs of tylenol 4 a month, I usually blow through them in 1-2 weeks because of flareups and my pain is 24/7. I have been afraid to talk to my doctor about it because they tend to over react when you take more meds than your prescribed. I bear with the pain the rest of the time until my next refill. I have only had withdrawal symptoms once when I got off buprenorhine and I know what that feels like and I have never experienced that since. I do get mild cravings that usually come up when I'm in pain or when I have an emotional trigger but they do fade and its not like "I have to have it". I do love the feeling they give but if given the choice of staying like this or moving on, I would move on in an instant. My family thinks I have an issue but they do not understand what I go through. I recently saw a psychiatrist about pain and other stuff and she said the opiates are making my pain worse and that I'm addicted/dependent on them, she assumes I have been taking them consecutively for the past 5 years when really for the last 3 I haven't because of a 1-3 week gap between refills giving by body time to reset. She wants be to go off them, said it would take 6-12 months for things to clear up and that I would have a lot of pain which I already have. If I have an issue I think it is mild and if not I don't want to go through a year of extreme pain just to find out the codeine wasn't the issue.

What do you guys think?
 
In my case I was in much more pain due to opiate meds as after I became dependent and then addicted they would magnify my original pain and it got to where I was taking them round the clock. I did that for alot of years and for the first two I wasn't an addict. I could take large amounts and be cool for a week or two, but that doesn't last forever. When it catches up to you it makes up for the lost time.

I think the reason I didn't have dependency issues sooner was because I had a constant supply.
The psychology of want and need wasn't as intense as if I had to buy them per pill off someone.
Knowing that script will be filled is much better than your only source drying up, I had a doctor stop prescribing out of no where and that was the one of worst experiences in the world, which drove me to methadone and heroin and a decade of addiction.

6-12 months I think sounds a bit much. I was an addict for 12 years and I got clean and it took 3 months to feel like myself again and 6 to back to normal which is pretty huge because I don't even remember what life was really like before opiates. But I think mental health uses those numbers to get you paying for services and making ppl dependent. They use therapy like drugs imo. It;s really hard to find someone in the mental health community that is honest and real. If those services seriously help, use them and anything that helps. But have allot of experience in having mental health professionals try and treat my addiction and it always made things much worse. There was a time I was seeing doctors 3-4 times a week, after I got off pills and heroin and that was so unnecessary. But I know they look at us like lifetime customers as they are catering to anyone who ever used a drug as permanently damaged.

I had a botched surgery with lots of nerve damage.
It took a really long time for those nerves to link back up and work correctly.
Is there anyway you can get the source of your pain fixed?

The only way I was able to get better was knowing I couldn't take any opiate from anyone as I can't handle them and I doubt anymore that anyone can with years of use.
That led to me getting my life and body back, everything I did after I came to that conclusion helped me and could not be accomplished if I didn't realize and make that decision, and I am very grateful for it.

Best of luck jjj
 
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Thanks for the Reply David

I think it helps a lot more to take with people that have dealt with it than a doctor or psychiatrist and I can be fully truthful and open about it. They are judgmental, don't trust a word you say, and view you as a junkie. I don't know of a way for my pain to get better, I have tried everything and have just given up. I don't have an issue getting off the drugs, I am just afraid of not having anything to cope with the pain and OTC meds don't help at all. I can't stand psychiatrists, psychologist, and therapists. They are expensive, see issues where there is none, and I don't find therapy helpful and that it is just a waste of my time.

I was wondering about tramadol? It helps as a painkiller and it also has antidepressant properties. I do not a tolerance, the same dose has been effective for the past 3 years. I have had my metabolic enzymes tested for medical reasons, I am an intermediate metabolizer of CYP 2D6 and I think that is a reason why I am not as dependent as I could be because less codeine is being metabolized into morphine.

I can talk it over with my doctor and see what he thinks but I really don't want to bring it up.
 
I totally agree with the doctor that cronic and continuous treatments with opiates end up making pain much worse.

This could be especially true since your threading the needle like you are. It may also make the opiates work well when you take them

Your "natural" pain level can be reached by most people in under nine months of abstinence from opiates.

If you evee want to check yours I think you could heal much faster due to the wise time off you take off.

Im fairly amazed that after five years of use you do not exspierence really noticeable withdraw symtoms. Is it posible that you may be grouping the withdrawl symtoms in with the pain from your condition?

If you dont have any phisical withdrawl symtoms then your not dependent.

Your post shows some common indication of addiction. So you may want to explore that possibility.



-Do you ever have useing dreams
-Do you crave useing
-Do you often fantasize about useing or about your script day comming around.
 
CfZrx said:
^can u explain this more please? Your "natural" pain level can be reached by most people in under nine months of abstinence from opiates.
Click to expand...


I'm curious myself, but I think he means that when you're on opiates you're able to handle more pain or have a higher pain level, but when you're WDing and even for a period after the physical stuff stops you have a lower pain level. Basically just means that things seem to hurt more than usual. The higher and lower is based on what your "natural" pain level was prior to any opiate use. I could be completely off and apologize if I am.
 
Is it posible that you may be grouping the withdrawl symtoms in with the pain from your condition?
It is possible, I generally don't have a lot of energy or motivation but I also have depression so it is hard to tell.


-Do you ever have using dreams
no
-Do you crave using
occasionally but it usually has a trigger
-Do you often fantasize about using or about your script day comming around.
no, I don't fantasize about my script day but it is on my mind especially when my pain is flared up

I have been on lithium (not for bipolar) for awhile and I have found it kills the cravings.

My pain does fluctuate a lot though, some months are better than others despite being on the same regimen. I have no tolerance, the same dose of codeine has worked since I started. I do have some issues with control though, If I have them I use them sometimes when I don't need to. But I have issues with self control, with other other things. Other than he pain killers chiropractic adjustments help the most but they have really compounded the issue by making my spine hyper mobile and unable to hold alignment which is where I think a lot of my issue is coming from.

This last month I was doing exceptionally well but I was on a corticosteroid and all my pain symptoms were mild to none existent. I had no cravings and I was good up until this last week when work caused it to flare up and that is when my cravings started. I refilled my script yesterday and I feel a lot better but this flare up is worse than usual so Im still in a lot of pain. My flare ups usually last 1-2 weeks if there bad. If I have my Rx at the time of my flare up it will get me through it and when I run out it doesn't come back until the next time.

I agree I have some mild addiction issues but I'm not worried about it. I am a very objective person but I feel I am being a little biased towards the drugs. i can rationalize pretty much everything.

What is threading the needle?
 
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Carl Landrover said:
I'm curious myself, but I think he means that when you're on opiates you're able to handle more pain or have a higher pain level, but when you're WDing and even for a period after the physical stuff stops you have a lower pain level. Basically just means that things seem to hurt more than usual. The higher and lower is based on what your "natural" pain level was prior to any opiate use. I could be completely off and apologize if I am.
Click to expand...
Thanks! I have considered whether I should even be on opiates for my arthritic neck. I lived with the pain from when it started for 1 year, before my doctor could tell I was suicidal and finally scripted me a low dose morphine diet. I have even heard the great DR Drew say that our pain levels become manageable if we dont use opiates, but that wasn't the case at all for me. Is neck arthritis one of the worst pains?
.
 
CfZrx said:
^can u explain this more please? Your "natural" pain level can be reached by most people in under nine months of abstinence from opiates.
Click to expand...

Here is some info on it.

Opioid-induced hyperalgesia

A Comprehensive Review of Opioid-Induced Hyperalgesia

So what I think goes on is this.

We get injured or whatever and we find ourselves in very uncomfortable pain.. we are prescribed or take opiates to treat the pain.. bamm, money right.. works like a charm initially.. Opiate pain killers given to a person who has almost never taken opiates and given for a very short course of treatment (days to a couple weeks) seems to be a very beneficial approach.

So say we use the 10 point pain scale (which was created by big pharma;)..

Something happens and we find ourselves in pain.. lets say we are at a nine on the scale.

So 9.. Then we take a pain medication and the pain is relieved to a three. Good things.

The problem is the brain likes it homeostasis and if the pain medication is taken chronically the brain will adjust to the pain med being present in the system.

So for the first two weeks the 9 went to a 3 and slowly increased until the next dose of the the medication..

But the brain then starts to adjust to the medication being present.

So initially we went six points in a beneficial way upon taking the opiate. What happens when the brain starts to adjust though.

So what might happen when it starts to adjust is that instead of dropping to a 3 we instead drop to a 4, but when the pain meds wear off., we find we are at a ten instead of a nine.. then we take the med and find we only get relief to 5, but when it wares off we are at an 11... and so on and so forth..

So conceivably at the end of the brain compensating, we could experience pain at a level 15, six points higher than if we never took them at all.

But its really hard to see because we still perceive such strong "pain relief" when we take the medication.. who wouldn't feel significant pain relief going from a 15 to a 9.

Almost everyone I have followed here on BL has their brain stabilize from the chronic use of opiates after under nine months of abstinence. This includes their pain response returning to its normal level.

If they indeed ramp up the response then they have a good chance of feeling much less pain unmedicated at this point then they did almost all the time medicated.
 
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Should I stop taking them despite the fact I do not feel dependent, or because I do not think they have exacerbated my pain?
 
I never go over 4 grams of APAP/day regardless if I'm still in pain. Pain varies from 6-8/10 during a flareup and drops to ~2-4/10 with meds and the effect has been consistent since I have been on them.
 
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