Posted by Holly VanBen on September 22, 2006, at 14:59:24
In reply to Re: Tentative Withdrawal From Oxycodone » Holly VanBen, posted by corafree on September 20, 2006, at 7:33:46
Hi cora,
OK this is alot of info and it is not mine. I pulled it right off the PA website. It answers many of your questions. Particularly dependance versus addiction, tolerance, withdrawals and help. Please at least skim through it, it should help alot.
Accidentally Addicted?Donna, a 34 year old lawyer suffered from extreme anxiety, coupled with panic attacks. She sought the help of a psychiatrist who put her on Xanax. It helped with the symptoms for a little over a year. She then noticed she was beginning to feel more and more anxious in between doses. In addition, the dose she was taking barely helped anymore. She reported this to her psychiatrist and he responded by increasing her dosage. In less than three years, he had increased the dose to five times the amount she was first prescribed.
She was honest with her psychiatrist and he increased the dose to what she said she needed. She had convinced herself that prescription drugs were safe. She rationalized this by saying to herself, “if her psychiatrist prescribed them, they must be okay. And besides, a reputable drug company developed the pills in a nice clean laboratory, so how could they be dangerous?”
She began to feel increasingly depressed. She dreaded leaving the house. Her panic attacks increased in frequency whenever she did venture out. She did not want to see her friends. She did not answer the phone. Her world was becoming smaller and smaller.
Donna called her doctor and told him she wanted to get off the pills. He suggested a slow tapering off process and they decided that her partner, Beth, would give her the agreed upon dose each day.
She really wanted the tapering off to work, but she began to feel sick in between doses. She tried to follow the schedule, but she couldn’t tolerate the withdrawal symptoms. She would wait until Beth left for work in the morning and then tear the house apart looking for the pills. When she found them, she “stole” a few and put the vial back where Beth hid it. She pretended to continue the agreed upon tapering off process.
Donna panicked when she realized she was taking more than twice the amount she was supposed to take. Feeling like a failure and filled with shame, she did not tell her doctor. She went to another psychiatrist to get another prescription. Her partner begged her to get help. Donna didn’t feel that she could live without her pills. Her life had become completely controlled by Xanax. She would panic when she was beginning to run out.
Donna’s world was now focused on conning, getting, and taking the pills. She would count them over and over again when she picked up a new prescription. One night, several months later, Beth found Donna unconscious on the floor by the bed. She was rushed to the emergency room. When she regained consciousness, the resident informed her that the Xanax had become toxic in her bloodstream and that she would not have lived more than two weeks had she continued taking them. She had no choice but to stop. She was medically detoxed in the hospital and sent to a treatment facility to continue the process and begin to learn to live drug-free.
What leads a person to become addicted to prescription drugs?
Prescription drug addiction is no different from alcoholism or an addiction to any other substance. However, no one is prescribed alcohol or cocaine for medical reasons. People who suffer from chronic pain are in a very difficult position. Painkillers do relieve pain. For people who suffer from constant and chronic pain, narcotics may be necessary to allow them to have any quality of life. The downside is becoming physically dependent and risking the possibility of addiction.
While it is true that the drugs themselves are highly addictive, not everyone who takes painkillers becomes an addict. The statistics of those suffering from chronic pain who become addicted to these drugs are actually pretty low according to the Chronic Pain Advocacy League, a grass roots organization dedicated to helping those who suffer the debilitating effects of chronic pain. However, this is not to say that those who suffer with chronic pain are not at increased risk of prescription drug addiction.
According to the Journal of the American Medical Association, the area of pain and chemical dependency has become an increasingly important issue. Although chronic pain affects over 45 million Americans--more than either cancer or heart disease--treatment is a low priority in the current health care system (Chronic Pain Advocacy League).
A recent survey by the National Institute on Drug Abuse at Columbia University indicated that approximately 50% of primary care physicians have difficulty speaking with their patients about substance abuse (FDA Consumer Magazine, Sept.- Oct., 2001).
Tolerance
Drug tolerance is basically the body's ability to adapt to the presence of a drug. When narcotic substances are taken regularly for a length of time, the body does not respond to them as well. Tolerance then becomes defined as a state of progressively decreased responsiveness to a drug as a result of which a larger dose of the drug is needed to achieve the effect originally obtained by a smaller dose.
Dependence or Addiction
There is a difference between dependence and addiction. Dependence occurs when tolerance builds up and the body needs the drug in order to function. Withdrawal symptoms will begin if the drug is stopped abruptly. On the other hand, when a person is dependent on the regular use of a drug to satisfy physical, emotional, and psychological needs, they are addicted to that substance. Physical dependence exists as well, but the drug has become a way to cope with all kinds of uncomfortable feelings.
Many prescription drug addicts do begin by needing the drug they are prescribed for medical reasons. Somewhere along the line, however, the drug begins to take over their lives and becomes more important than anything else. Nothing will stop them from getting their drug of choice.
It may be difficult to understand how someone could let this happen. How could someone who is reasonably intelligent and sophisticated in regards to drug addiction become an addict? Addiction has nothing to do with intelligence. And addiction to prescription drugs is no different than any other substance abuse problem. Many people in the medical profession abuse prescription drugs. Health care providers may have a slightly higher rate of addiction due to both the stressful nature of the work and their relatively easy access to supplies of narcotics. Clearly, the potential risks and dangers involved with taking narcotics are not unknown among health care providers. This, however, doesn’t stop someone from becoming an addict. Some 12-step members have described addiction as a disease of the emotions.
Addictive Behaviors
Along with addiction, there are addictive behaviors that are quite common among addicts. Lying, keeping secrets, hiding pills and obsessively counting them, making unnecessary emergency room visits and constantly "doctor shopping." As the addiction escalates, engaging in such illegal activities as stealing prescription pads, committing forgery, and buying drugs off the street is also quite common behavior.
These behaviors usually stem from the desperation an addict feels regarding getting, securing, and taking their drug of choice. Under other circumstances, the individual would probably not engage in the behaviors listed above, unless they were previously part of his/her personality structure. In other words, addictive behaviors are limited to the addiction itself and are generally dissonant with the person’s beliefs and values in any other area of their life.
Shame and Guilt
Both shame and guilt are feelings that are very common to the experience of addiction. No one wants to be a drug addict. There is tremendous shame in having your life ruled by a vial of pills. There may also be a tremendous amount of shame and guilt about the type of behaviors you can become capable of engaging in to get drugs. The way one behaves on pills--falling down, slurring one’s words, blackouts--are all shameful experiences.
A person whose become addicted to prescription drugs may feel guilty about the way they have treated others, particularly those closest to them. There’s a great deal of guilt associated with lying and betraying the people they love.
Neither shame or guilt is conducive to getting the help that is needed. In fact, these feelings can be quite destructive. Shame can prevent you from getting treatment. Guilt can lead to all kinds of self-destructive behaviors that will interfere with sobriety. Bottom line: shame and guilt lower self-esteem and foster self-hatred.
Getting Help
There are many treatment facilities located throughout the country. Many insurance plans cover inpatient detox. Some insurance companies will pay for a week, maybe two. Some may pay for rehab as well. It’s important to get help and not to try to get off pills on your own. Some people may feel that they can’t afford to take a week or two out of their lives to spend in a treatment facility, detoxing. The demands of children, a job, school, or other responsibilities may make inpatient treatment seem like a luxury. It is not. It is unquestionably better to leave the routine responsibilities of your life for a week than it is to suffer the inevitable outcome of prolonged drug addiction.
Withdrawal
When an individual becomes physically dependent on painkillers or benzodiazepines, they should not just suddenly stop taking them. Stopping suddenly can cause seizures and possibly even death. The risk of a seizure is actually quite high. Dependency might be dealt with by tapering off the medication. Some people have been successful using this approach. Addicts have often found tapering to be unsuccessful because their addiction is both physical as well as psychological. If tapering is done inpatient, it has more of a chance of success.
Withdrawal symptoms can be, and often are, difficult. Benzodiazepines, for example, are stored in the tissues and fat cells. Getting the drug out of your bloodstream can take a long time. Drugs that go through the digestive tract are more quickly excreted.
Even when someone detoxes inpatient, the symptoms often feel unbearable. While the acute withdrawal symptoms generally last a couple of weeks, the prolonged withdrawal, called Post Acute Withdrawal Syndrome (PAWS) lingers. These symptoms have been known to last a year or longer.
In addition, the person who suffers from chronic pain may initially be in more pain than they were before they began to take painkillers. Painkillers and benzodiazapines repress the body’s natural production of dopamine and endorphins (the “pleasure center of the brain”) and take over their function. After the drug is detoxed, it takes some time before the body’s natural pain receptors “wake up” and begin to function normally again.
What other options does someone who suffers from chronic pain have? After becoming drug-free, this issue still needs to be addressed. Some people believe that they can never take prescription narcotics again and need to remain abstinent for life. Other methods of pain relief like meditation, breathing exercises, yoga, or biofeedback may provide some relief. For recovering addicts who need to be on narcotic painkillers, having someone else responsible for the medication may be a good idea.
How do you know when someone needs treatment?
If you are unsure whether you or someone you know has a problem with prescription drugs, here are 20 questions that can help you become clearer about whether or not you’d benefit from help:
1. Has your doctor, spouse or anyone else expressed concern about your use of medications?
2. Have you ever decided to stop taking pills only to find yourself taking them again contrary to your previous decision?
3. Have you ever felt remorse or concern about taking pills?
4. Has your efficiency or ambition decreased since taking pills?
5. Have you established a supply for purse or pocket or to hide away in case of emergency?
6. Have you ever been treated by a physician or hospital for excessive use of pills (whether or not in combination with other substances)?
7. Have you changed doctors or drug stores for the purpose of maintaining your supply?
8. Have you received the same pill from two or more physicians or druggists at approximately the same time?
9. Have you ever been turned down for a refill?
10. Have you taken the same mind- or mood-affecting medication for over a year only to find you still have the same symptoms?
11. Have you ever informed your physician as to which pill works best at
which dosage and had him adjust the prescription to your recommendations?12. Have you used a tranquilizer or a sleep medication for a period of months or years with no improvement in the problem?
13. Have you increased the dosage, strength or frequency of your medication over the past months or years?
14. Is your medication quite important to you; e.g., do you worry about refills long before running out?
15. Do you become annoyed or uncomfortable when others talk about your use of medications?
16. Have you or anyone else noticed a change of personality when you take your medication, or when you stop taking it?
17. Have you ever taken your medication before you had the associated symptom?
18. Have you ever been embarrassed by your behavior when under the influence of your prescription drug?
19. Do you ever sneak or hide your pills?
20. Do you find it impossible to stop or to go for a prolonged period without your pills?
(Reprinted and slightly adapted from "There's More to Quitting Drinking than Quitting Drinking" by Dr. Paul O.)
If you have answered YES to three or more or these questions, you may be at serious risk of having a problem. The good news is that treatment is available.
Treatment
There are many avenues for treatment. Inpatient treatment, under complete medical supervision is a safe and effective way to detox. This will cut down the risk of seizures and other health-related concerns.
Outpatient group therapy can be an effective way to transition back to a sober life.Individual psychotherapy can be very helpful in dealing with all of the feelings involved in letting go of prescription drugs, not to mention discovering what led one to become addicted to them in the first place.
Conclusion
Not everyone succinctly stops using drugs, gets clean, and begins recovery. Getting past the denial and resistance common to most addicts is difficult. Some people need to "hit bottom" before they are willing to quit. Others may be more fortunate and embrace recovery before losing everything and everyone in their lives. Unfortunately, there are still many addicts that never make it back and die before they can ever get help.
poster:Holly VanBen
thread:684185
URL: http://www.dr-bob.org/babble/wdrawl/20060809/msgs/688211.html