Addiction versus Dependence: A Call for Public Education

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Updated April 24, 2015.

Pain creates a devastating situation for sufferers and those around them. Pain, especially chronic pain, is a debilitating, very dehumanizing condition. Albert Schweitzer said, "Pain is a more terrible lord than death itself." The more severe the pain, the more it may overshadow one's intelligence. All one thinks about is the pain: there is no past, no pain-free memory, no pain-free future, only the pain-filled present.

Pain destroys autonomy: the person is afraid to make the slightest movement. All choices are focused on either relieving the current pain or preventing greater future pain and for this one will sell one's own soul.

According to the National Foundation for the Treatment of Pain (NFTP) chronic pain is almost universally accompanied by anxiety and depression. Suicide is not uncommon. Chronic pain is also a damaging, and even deadly, destructive disease with physical, psychological, and behavioral consequences. Chronic pain compromises the immune system and slows healing. It causes cell damage and death. Untreated pain "rewires" the nervous system so that even when the original cause of pain is removed, pain may continue. This "rewired" pain can be even harder to treat than the original cause.

Chronic pain is costly to our society, affecting as many as 50 million Americans to the extent that they cannot work productively and become either partially or fully disabled. It's one of the most frequent causes for Social Security Disability Insurance claims and dramatically affects state, federal and private health care costs.

The NFTP estimates the total cost of untreated and under-treated pain approximates $100 billion a year attributable to lost workdays, excessive or unnecessary hospitalizations, unnecessary surgical procedures, inappropriate medication and patient-incurred expenses from self-treatment.

Untreated and under-treated pain is widespread in the U.S.. Experts estimate as much as 95% of all pain can be reduced to manageable levels. Yet, it isn't. An American Pain Society survey in 1999 revealed 54 million adults experience long-term moderate to severe pain annually, and only 25% received adequate treatment.

As part of a well-intentioned, ongoing "War on Drugs" the majority of the media and law enforcement community continue to promote a very limited view of pain medication and its use/abuse. The one-sided portrait they paint includes only negatives such as misdirected prescriptions, illegal use/abuse and addiction, not to mention the horrible consequences associated with such behaviors. Their crusade to educate the public and medical community of the perils of prescription drug abuse in some situations causes much more harm than it does good for it drives pain sufferers away from the proper treatment of their condition.

Opioid medications can be extremely effective against many types of pain. They are, among many other uses, one of the last lines of defense when back or neck surgery is unsuccessful. As other medicines, from insulin to aspirin, they too have side-effects and must be carefully managed and taken only as prescribed.

A couple of factors, including the fear of their patient becoming addicted and/or a fear of sanction or prosecution, substantially reduce physicians' willingness to prescribe narcotics and, to some extent, the patient's willingness to accept narcotic therapy. These have been exacerbated by the recent hysteria in the media surrounding the OxyContin.

Fear of addiction... There is a belief dramatically fostered within the United States by the spread of misinformation that anyone who takes opioid medications is at substantial risk of addiction. In fact, the rate of addiction amongst those who are treated by a doctor with opioid medications is no greater than that of addiction in the general population. According to the National Council on Alcoholism and Drug Dependence there is a solid body of clinical evidence that patients with a history of substance abuse or alcoholism may have a genetic predisposition to poor control of their medications and to addiction. Physical dependence and tolerance are different matters: anyone who repeatedly takes opioids, whether for medication or to feed their addiction, more than likely will become physically dependent on the medication and encounter withdrawal if he/she stops taking it abruptly.

Ability to function divides the addict from the physically dependent pain patient. The Florida Board of Medicine explains addiction is characterized by "compulsive use, despite harm." Addicts become socially less functional as the drug takes over their lives. All thought revolves on where their next dose is coming from. Addicts are less able to handle their jobs, family obligations and social participation.

>>Please follow the link below to read the end of this article.<<

People are suffering and dying as a result of misinformation. It must stop.
Pain creates a devastating situation for sufferers and those around them. Pain, especially chronic pain, is a debilitating, very dehumanizing condition. Albert Schweitzer said, "Pain is a more terrible lord than death itself." The more severe the pain, the more it may overshadow one's intelligence. All one thinks about is the pain: there is no past, no pain-free memory, no pain-free future, only the pain-filled present. Pain destroys autonomy: the person is afraid to make the slightest movement. All choices are focused on either relieving the current pain or preventing greater future pain and for this one will sell one's own soul.

According to the National Foundation for the Treatment of Pain (NFTP) chronic pain is almost universally accompanied by anxiety and depression. Suicide is not uncommon. Chronic pain is also a damaging, and even deadly, destructive disease with physical, psychological, and behavioral consequences. Chronic pain compromises the immune system and slows healing. It causes cell damage and death. Untreated pain "rewires" the nervous system so that even when the original cause of pain is removed, pain may continue. This "rewired" pain can be even harder to treat than the original cause.

Chronic pain is costly to our society, affecting as many as 50 million Americans to the extent that they cannot work productively and become either partially or fully disabled. It's one of the most frequent causes for Social Security Disability Insurance claims and dramatically affects state, federal and private health care costs. The NFTP estimates the total cost of untreated and under-treated pain approximates $100 billion a year attributable to lost workdays, excessive or unnecessary hospitalizations, unnecessary surgical procedures, inappropriate medication and patient-incurred expenses from self-treatment.

Untreated and under-treated pain is widespread in the U.S.. Experts estimate as much as 95% of all pain can be reduced to manageable levels. Yet, it isn't. An American Pain Society survey in 1999 revealed 54 million adults experience long-term moderate to severe pain annually, and only 25% received adequate treatment.

As part of a well-intentioned, ongoing "War on Drugs" the majority of the media and law enforcement community continue to promote a very limited view of pain medication and its use/abuse. The one-sided portrait they paint includes only negatives such as misdirected prescriptions, illegal use/abuse and addiction, not to mention the horrible consequences associated with such behaviors. Their crusade to educate the public and medical community of the perils of prescription drug abuse in some situations causes much more harm than it does good for it drives pain sufferers away from the proper treatment of their condition.

Opioid medications can be extremely effective against many types of pain. They are, among many other uses, one of the last lines of defense when back or neck surgery is unsuccessful. As other medicines, from insulin to aspirin, they too have side-effects and must be carefully managed and taken only as prescribed.

A couple of factors, including the fear of their patient becoming addicted and/or a fear of sanction or prosecution, substantially reduce physicians' willingness to prescribe narcotics and, to some extent, the patient's willingness to accept narcotic therapy. These have been exacerbated by the recent hysteria in the media surrounding the OxyContin.

Fear of addiction... There is a belief dramatically fostered within the United States by the spread of misinformation that anyone who takes opioid medications is at substantial risk of addiction. In fact, the rate of addiction amongst those who are treated by a doctor with opioid medications is no greater than that of addiction in the general population. According to the National Council on Alcoholism and Drug Dependence there is a solid body of clinical evidence that patients with a history of substance abuse or alcoholism may have a genetic predisposition to poor control of their medications and to addiction. Physical dependence and tolerance are different matters: anyone who repeatedly takes opioids, whether for medication or to feed their addiction, more than likely will become physically dependent on the medication and encounter withdrawal if he/she stops taking it abruptly.

Ability to function divides the addict from the physically dependent pain patient. The Florida Board of Medicine explains addiction is characterized by "compulsive use, despite harm." Addicts become socially less functional as the drug takes over their lives. All thought revolves on where their next dose is coming from. Addicts are less able to handle their jobs, family obligations and social participation.

>>Please follow the link below to read the end of this article.<<

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