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Back Problems Message Board

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[QUOTE=injured betty]So, benzo, addicts or not? Any of you who think that pain pills are not an addiction should wander over to the pain board. There are a lot of people there who started out where you are.[/QUOTE]

I've been a member of the Pain board a long time and they don't say much different from what I described. I won't argue your point as it seems moot, we do all have our own opinions for various reasons and I can respect that.

Yes we can go through withdrawls but this does not define one as an addict. I've even gone through them recently when my medications got all messed up, that doesn't define me as an addict.
There's a distinct difference between dependance and addiction but it appears it is difficult for some to understand or define that.

At any rate here's what I was referring to in terms of addiction vs. dependance vs. tolerance. Of course most of the information is nothing we aren't already aware of but it is what my doctor and many others are telling patients with CP. It's about the best information I can offer in terms of how I and many others understand it. If one chooses to believe that anyone is an addict because they need to take narcotics to have normalacy in their life that is their choice but it doesn't always mean it is the correct answer.

I have bolded the area's I have tried to explain, hope that helps you to understand how I percieve it, again, it doesn't mean I am correct either.
Can addiction happen? Yes, but the percentage really is small due to how the medication works in regards to our pain receptors.

[b]Opioids[/b] (narcotics) are medications that work like morphine. There are many drugs in this class. Examples of some include methadone, demerol, percocets, vicodin, oxycodone, and heroin. Opioids bind to a variety of different receptors on nerve cells in the CNS (central nervous system) and elsewhere in the body, leading to pain relief as well as the various side effects. Different opioids have different affinities for the various receptors and their subclasses on different cells, and this gives each opioid a unique blend of various responses (pain relief and side effects). They cause pain relief by decreasing pain impulses and sensations after binding to the nerve cells in the spinal cord and brain. They also can cause many side effects including sedation, respiratory depression, nausea, constipation, and sometimes mental status changes by affecting other nerve cells in the body.

Unfortunately, [b]over time, nerve cells become accustomed to the effects of the opioids, and therefore, over time, opioids will have less of an effect in decreasing pain impulses and sensations. This is called Tolerance; the body becomes somewhat tolerant to the effects of the opioids[/b]. This develops in everybody who takes opioids chronically. A patient may find that the medication will not seem to work as well as it did in the beginning. This is to be expected. Even though they will develop tolerance, it will not be complete, and the medications will always give them some relief. There may be times when they may feel that the medications are not helping them at all. I’m sure that if they were to stop taking them for a day, their pain would worsen. The main point of this is that with the use of opioids, the goal is only partial relief, NOT complete relief, since the latter is unattainable due to the development of tolerance.

There is no treatment to prevent the development of tolerance. Increasing the dose of opioids to counteract tolerance will only subsequently increase the level of tolerance. The body will re-adjust to the new higher dose of opioid, and the degree of pain relief will ultimately be no better than that previously achieved with the lower dose of that opioid.

Opioids are the main medications used for the treatment of acute, severe pain, such as experienced following surgery, bone fractures, or any other severe injuries. If a patient already has a high tolerance to opioids, they will not work well or not at all using standard doses, if and when a patient needs them to treat severe, acute pain. Therefore, it is important for a patient to minimize the use of their opioids, to minimize their development of tolerance, so as to preserve the ability of their body to respond to opioids for pain relief should they experience severe, acute pain.

[b][u]Addiction is the craving of opioids for reasons other than pain relief[/u][/b], and is different from tolerance. With time, everybody develops some degree of tolerance, but [b][i]only a small fraction of patients become addicted to or abuse opioid medications[/i][/b].

[b]Withdrawal occurs when a patient, who is taking a large quantity of opioids, suddenly stops taking them.[/b] With taking opioids chronically, the body becomes accustomed to a high level of them, and when this level suddenly drops, various different cells in the body respond, and this results in withdrawal symptoms. Examples of some symptoms include diarrhea, tachycardia, and anxiety. Most patients are only using relatively low doses of opioids, and if they would stop them suddenly, they probably wouldn’t have any withdrawal symptoms at all, or if they did, they would be very mild. Increasing pain would be a greater problem

I hope that clarifies my point of view.

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