I have a question for anyone who can answer it:
How do you define addiction in an individual who craves his next dosage of Xanax because of a feeling of an impending, massive panic attack?
I think that, too often, those of us who suffer from illnesses which warrant the use of controlled substances, are falsely labelled as "drug abusers" or "addicts" based on behavior which should probably be considered very rational rather than very abnormal (which addiction implies, FWIU).
Other examples which come to mind, which lead to the patient being accused of "abusing" his or her Rx drug includes the length of time (s)he is on the medication, and also the dosage, and even the medication itself in certain cases. And if that latter example doesn't show how stigmatized certain people who are suffering from chronic, long term, severely painful diseases must feel, then I don't know what does.
Don't worry - I'm not wallowing in self pity, but I've had my fair share of dirty looks simply because I was at a pharmacy to pick up a prescription for a controlled substance. Narcotic analgesics are usually numero uno on the list in relation to dirty looks from the pharmacist, and/or one or more of the pharmacy technicians. How YOU doin'?! Biatch.
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If it's not too much to ask, please read the following example regarding the consequences of (certain) recreational drug stigmatization:
Mr. Suq Madeiq has been dealing with severe anxiety and panic attacks for the past decade or so after having a mental breakdown due to job-related stress, lack of sleep, poor (fast food) diet, and being the victim of a violent robbery in which the thieves staged a mock execution.
During the mental breakdown, Suq thought he was experiencing a heart attack, as his limbs went numb, his heart began pounding and skipping beats, he had trouble breathing, and soon got really dizzy.
One of his coworkers witnessed what happened and quickly called for an ambulance, and Suq was rushed to the nearest ER. Thankfully, tests came back negative, and the mental breakdown was ruled just that, or more specifically, a severe panic attack - Suq's first, which is why he was convinced that he was dying from acute heart failure.
Upon the advice of supportive family members, Suq went to see a psychiatrist, who prescribed him Xanax (Alprazolam) 0.5mg TID.
Suq was scared shitless to use any Rx drugs, let alone a psychotropic one - ergo he filled the Rx but did not dare to take any.
That was until about a week later when a series of unfortunate events culminated into a recipe for a massive panic attack. And once he began to notice this happening, Suq decided he'd rather take his chances with the medication.
Approximately 1 hour later, Suq felt remarkably calm - even a little euphoric. But was this feeling of euphoria due to his sheer joy at finally feeling free of any anxiety? Or was it all because of the reward pathway reinforcing effects of the benzodiazepine? Or both perhaps?
Fast forward 5 years, and Suq is still on the same dosage of Xanax. Oddly enough, it still seems to have have a therapeutic effect for him, but no one will believe him.
In fact, a few months ago, Suq voluntarily attended a rehab program for people with mood disorders because he heard good things about it. And he was hoping that by attending, that it would help him to manage his anxiety/panic attacks eventually without the need to use medication.
Suq was upset to discover upon his arrival that the nurses and psychiatrist there labelled him a benzo addict on his medical chart for no reason other than the fact that he has been on it for so long. This really bothered him. He felt unfairly judged by "experts" who never met him in person, but he remained in the program regardless.
Once he finished rehab, Suq took a look at his discharge medical notes, and was glad to notice that his "benzo addiction" diagnosis was changed to "benzo dependency." And before leaving for good, he decided to speak to the medical team about it.
So upon asking the aforementioned staff about the chance from "benzo addiction" to "benzo dependency," and what was it that made them realize he wasn't an addict, he was told that they realized this because he repeatedly forgot to show up on a regular (daily) basis to pick up his Xanax.
More specifically, he was supposed to show up three times a day to pick up the Xanax - (1) in the morning; (2) at noon; (3) and at around dinner time. And more often than not, he forgot to show up for at least one (and sometimes two) doses out of three in total. In fact, it became so regular with Suq that he was formally warned that it could result in him being kicked out of the rehab program.
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Assuming you managed to read the boring short story above, and assuming that you have first-hand experience with long term benzo use (therapeutically or recreationally), I'd like to know whether you thought Suq was an addict or not. Perhaps he simply forgot to show up because of short term memory issues? Or maybe it was because he felt no need to take anymore? What do you think? I'm genuinely curious, if you don't mind (because this is based on a true story).