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Old 02-01-2004, 10:41 PM   #1
TryingToSmile
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Join Date: Nov 2003
Location: San Diego
Posts: 98
Question Addiction vs. Tolerance (LAYNESAddiction)

Hey there! First and foremost, I hope everyone is doing as well as can be expected, and know that I read all your stories and keep you in my thoughts.
I thought I would give everyone a quick recap of my history first before I delve into my 'venting session' because I haven't posted much, but if you want to skip this, go ahead one paragraph!

I am a 25 year old female living in San Diego. I currently have been tapering off a 10-12 daily Norco habit, along with coming down off 50mcg Duragesic patch (which is fentanyl). My doctor has been prescribing this for pinched nerves, chipped disks in my back for the past 1.5 years. Although I do need them for pain sometimes, I am very well aware that I have become dependant on them, and supplement the scripts with Online Pharms, ect. About a month ago, I made the very tough decision to call my doc and tell him I wanted to come down from the 50mcg patch to the 25mcg patch. This was a horrible, horrible couple a weeks to get used to the change. I have been through the hydro withdrawals quite a few times, but they were nothing compared to lowering my dose of the patch. I literally wanted to rip my arms off my joints hurt so bad. I was so ill I physically couldn't move for a week. Anyhow, at this point, I am only taking 3 Norco a day, and I am trying not to wear the patch unless I have real pain. I am actually surprised that I don't feel as horrible going from 25mcg to 0mcg than I did making that transition from 50mcg-25mcg. I feel incredibly depressed, and have these killer headaches and concentration problems, but I can deal with that a lot better than having the body aches, chills, and aching joints. I'm actually very proud of myself for being able to stick to a taper plan, because I never thought I could do it. I'm hoping by the end of February, I will be finished. So I'll really need some support here during this tough time.

So, that being said, I wanted to respond to a subject LAYNESAddiction mentioned on the 'To Anti-Suboxone Posters' thread. You discussed the addiction/tolerance/dependence issue, and how doctors tell us all kinds of different and conflicting views. This is your quote:
"If you are waking up in cold sweats everynight and your doctor gave you valium, you took 10mg every night as directed, or if they gave you 120 percs and told you to take 3 daily and you did so to control the compressed discs in your back so you can keep your job, youre still going to have w/d if you stop. That doesnt mean your an addict or "your body is addicted", that is an incorrect use of the word and even doctors do it ALL the time."

Well, I have a story to share about how true that is. That even the most educated doctors, who are supposed to be the cream of the crop make what I think to be a HUGE mistake in telling people the wrong thing about tolerance vs. addiction vs. dependancy. Most recently, I was so frustrated with a neurologist who I made the mistake of talking to about coming off the patch. I had a consultation with him for possible surgery, and he said he didn't want to operate on me because I am too "young" (I know, wierd) and that I should pursue other options, like PT, massage, medications. I told him I did not want to stay on opiates forever, and he said 'Well, just stop taking them, and take Motrin.' I said, well I am trying to taper down right now, so it will take some time to do that. So he said, "Do you think you are addicted?" And although I am, I wasn't going to fully disclose that. So I said, "Well, I've been taking the medicine for a 1.5 years, and have been on the patch, so that has been providing 24/hr a day release of medication into my system. I can't just take it off when I feel better (if you did, you would run out of the medication real quick because you are supposed to wear them for 3 days, and if you take it off, it won't stick back on, and the medication evaporates.) When the pain tells me I don't need as much Norco, I just take fewer pills, but the patch makes it more complicated. So I don't think I'm addicted, but my body is physically dependant on it right now, since its been slowly released into my system for a year and a half." And he kinda got quiet, and thought about this, and then said "So you have painful physical withdrawal if you were to just take the patch off?" And I said, "uh, yeah" and he said, "well then you are addicted." And I kinda got a little fired up, and said, "So you are telling me that someone else could have been on the same medication regimine I've been on for the same length of time, and they would be able to stop taking it one day and feel fine?" And he said, "ABSOLUTELY." I just sat there trying to figure out if I was in the twilight zone. He then went on to say, "Some people are genetically pre-disposed to becoming addicted to opiates. If you are feeling uncomfotable, and that you body needs it, you are addicted and we need to refer you to an addiction specialist." And I just kept trying to process his line of thinking. I mean, I'm not a doctor, but this just plain doesn't make sense to me. I said, 'then you don't believe in tapering off your patients?' He said, 'If you aren't an addict, tapering is non-applicable to that situation' I said, 'Well if thats true, why do all the informational phamlets they give you with your script tell you not to suddenly stop taking the medicine? And why does the bottle tell you its habit-forming?"
At this point, the doctor got pissy with me because he thought I was questioning his knowledge. But this just doesn't make sense to me. The doctor that referred me to this surgeon is the one who does my medication management, and he warned me before starting the patch that it would be physically VERY hard to stop taking it. So, according to this surgeon's line of thinking, my doctor must have known that I am genetically pre-disposed to be an addict, because if I was "normal," he wouldn't have to bother mentioning this? Bullcrap. I mean, doesn't everyone have opiate receptors that would react similarly if given the same quanity of medicine everyday? I realize that a non-addict would probably be able to manage their opiate usage better and recoginze that once the pain subsides, they take less medicine....so in theory, they are always on a slow taper, never taking the max amount allowed by the script, whereas I never can make the script last the whole month. Maybe thats why he thinks non-addicts can stop without problems, because they generally don't take the max amount.
Anyhow, I certainly don't believe him when he tells me that if a non-addict has severe pain for a year and a half and consistently took the same amount of medication I was taking (and I was allowed to use 10 Norcos a day, and the patch), and all of a sudden their pain goes away, that they would be able to stop their medication CT without discomforts. And this doctor kept swearing up and down that he is sure about that, and that if I have withdrawals, I shoud see an addiction specialist! What about cancer patients who are on massive doses of oxycontin, and the patch, and if their cancer is finally successfully treated after 3 years, are they going to feel normal after suddenly stopping the meds simply because they aren't genetically pre-disposed to being an addict? And when did having physical withdrawals/symptoms become the diagnostic critera for determing if one is an addict?? Anyhow, sorry about this long venting session, but when I read your post, it reminded me about how flustered I left after my appointment. Does anyone know if there is any shred of truth in what he told me? Common sense tells me 'no,' but I find it very disturbing that this man who would be operating on my spine seems to be so far off the mark about these medications (which he must prescribe regularly because he is a surgeon). Anyone else had a similar experience? Anyone know of any medical literature (articles/online info, etc.) that I could research on this topic to be more informed the next time I run into another donkey like this doc? Or am I just totally off the mark?

Well, thanks for listening to this VERY long story! I am keeping everyone in my prayers, and want to thank everyone for their help and support (even if I don't post much, I'm following everyone's stories, and rooting you on!)

Cheers!
Tryin'

PS- Has anyone else taken Trazadone (desaryl) while tapering? I am using it and it seems to really help the sweats, chills, etc. I can't say for sure that this is definitely what is making this process easier than all the times before, but this is the first time I've tapered (and more rapidly than what is recommended), and not felt like I was dying. Don't get me wrong, I don't feel anywhere close to normal or great! So I don't know if this would help anyone else... its a anti-depressant, and it acts as a skelatal relaxer, along with helping muscle and nerve pain, and it makes you sleepy (I think it lasts for 24 hours, so I always take it before bed). Anyhow, if anyone else has experience using this during tapering, let me know and we can discuss. I want to see if its been positive for anyone else.
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Old 02-01-2004, 10:54 PM   #2
Dilaudid_Hell
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Re: Addiction vs. Tolerance (LAYNESAddiction)

I was taking Dilauid for a year and a half and I was definately chemically dependent. I ended up in the emergency room when I ran out of meds and couldn't get a refill and was treated like scum by the Dr. there. What a jerk.

I decided that I needed to get off the meds, clear my mind and figure out what I was going to do about the chronic pain that got me in this mess. I didn't want to do joint replacement surgery until I had a clear head.

That doctor that you mentioned is an idiot. Anyone that takes pain medicine for a year and a half won't be able to stop without severe withdrawl. His lack of understanding of this is incredible. Scary to think that he got though med school.

Your in my same boat and I sympathise. Hang in there. Things will get better.

Dave
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Old 02-01-2004, 11:04 PM   #3
Banker
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Re: Addiction vs. Tolerance (LAYNESAddiction)

Hi - I am familiar with what you are saying. Let me give you an example that you actually used. My sister who is absolutely the farthest thing from an addict, was diagnosed with a brain tumor. Because of this, she had to go to Washington to have a new type of really strong radiation because her cancer was rare. Anyway, the radiation just tore her up so she was taking oxys and the patch. (I've taken the patch too and it is absolutely horrible to withdraw from... even methadone didn't help too much with it. I thought I was going to DIE). Anyway, she never, ever abused her meds and actually was only on them for a month. She used the patch occasionaly but more or less just took the oxys. She had lortab too but didn't take those much either. Anyway, she weighs about 105 lbs so she never took much at all. When she got home after taking these meds for a month... She was scared she was going to get addicted so she just stopped taking them cold turkey. She was in bed for over a week with the withdrawals from them. So, I've seen first hand how people who are not addicts, can still have withdrawals even taking them as prescribed. On the other hand, someone on here posted (and I can't remember who it was but it's been a while) but they said the same thing your doctor did. That normal people shouldn't have w/d symptoms if taking the medicine as prescribed and that the withdrawals are called "withdrawal syndrome". Maybe you can search on those words and find the post. Anyway, I have heard of it... I just don't know if I believe it. I'm really sorry you had to go through that and again, I know that fentanyl patch is some touch *&it to withdraw from... and I was only on it for 3 weeks. Take care of yourself and keep up the outstanding work. You are going to be drug free within a matter of weeks, if not days.
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Old 02-01-2004, 11:35 PM   #4
TryingToSmile
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Thumbs up Re: Addiction vs. Tolerance (LAYNESAddiction)

Thank you both for your support and encouraging words. It feels good to see in writing that I might be able to be clean in a couple weeks. I am so ready to be over this. I don't care about my back/neck pain anymore...I will not take that crap once I've finished my taper. I'll deal with the back/neck pain. Thats nothing compared to withdrawing from the patch. My god, thats an awful awful withdrawal.

Banker, how is your sister now? That sounds like a horribly scary thing to have happen. I don't know what I would do in your shoes. I sure hope she's doing well!
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Old 02-01-2004, 11:46 PM   #5
Banker
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Re: Addiction vs. Tolerance (LAYNESAddiction)

As far as the patch goes, again, I just don't know how you did it. I was taking 75 mcg and tried to drop down to 25 and there was absolutely NO WAY so I 'found' some methadone and stopped the patch completey. If I told you how I even ended up on it, you wouldn't believe it. Anyway, it was horrible and I wished I was dead during it. I can't believe you went from all of that down to just a couple of tabs a day. That is truly amazing. Also, I guarantee you that those tabs are doing nothing for your pain because of your tolerance so if you can handle the pain right now, you will be o.k.
My sister's cancer is completely gone. It was very unexpected but because she went to Seattle and went to the really strong radiation therapy... it killed that tumor quickly! Actually, that's another way I got addicted so severely to lortabs... She had hundreds and knew that I took them occasionally and let me just say, I thought it was Christmas... then, the wds kicked in and man... pure hell. Again, you're doing wonderfully!!! Just a matter of time now and you will be doing REALLY fine!!! K guys... I've got to go to bed here soon.
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