Executor

Hello Tara....I'll try to help as best I can....

First, there is a big difference between "addiction" and "physical dependence." Many use the terminology incorrectly, which only makes things more confusing. "Addiction" is when someone is mentally tied to a med or activity...For example, one can be a sex or exercise addict. The med or activity is consumed in order to derive a mental pleasure or stimulus.

Conversely, "physical dependance" is when one is physically tied to a med or chemical. For example, heavy coffee drinkers are physically dependent upon the coffee....If they don't consume it, they get a headache, some shakes, and overall, some form of WD.

Those who have legitimate pain don't get addicted....They become physically dependent....Over time. Yes, by increasing your meds, you will more than likely become physically dependent upon them at some point....Meaning if you don't continue to take them, you will get minor WD symptoms....Watery eyes, yawning, aches and pains, and etc. Full blown WD are flu like symptoms. Full blown WD only occurs when one comes to a complete stop abruptly.

If one has chronic pain and it is not tolerable, then IMO, some form of physical dependance is a necessary evil of getting proper pain relief and thus, functioning semi normally. If your Doc has given you instructions to take "as needed" then I would do just that....Take them when you have pain. Conversely, if you take them on some pre set schedule, then you may or may not be in pain, and this type of regimen will lead to faster tolerance and more dependance. Additionally, if you only take the med when you are in pain, they will be more effective overall.

Your concerns of going up in med strength are reasonable and it's good that you are thinking the way you are. However, in PM, there really is no ceiling, and over time, PM patients need their meds increased in order to account for tolerance. A good PM Doc understands this concept and usually has little to no reserve in increasing one's dose appropriately. The key word is "appropriately"....Meaning, the increases are spaced out and done prudently. Docs can tell when patients have legitimate pain and thus, aren't gettng relief vs. those looking for the mental pleasure, or addiction.

I have been in PM for quite a while and have gone through numerous increases and have even changed meds a few times. Sometimes changing meds can be a very powerful tool. Think of an example where you take Tylenol for a headache....Over time it doesn't work as well. if you switch to Motrin, chances are it will work much better as it's a different chemical structure and hits the receptors differently. Over time, the same will happen with the Motrin, however. But the good news is that you can switch back to the Tylenol and since your body has had a rest from the chemical, it works much better than when you previous stopped. In theory, one could rotate back and forth very effectively....Giving your body a periodic rest every so often. The same thing can happen in PM with narcotics, and your Doc knows what's best based on your particular condition and patient history.

Hope this helps. Feel free to PM me if needed.

Regards,

Ex