Awhile back, the Washington Post ran an excellent article by Maia Szalavitz on what exactly addiction is, and how we should go about treating the Britneys and Lindsays out there.
To get to the article, click here. Below are excerpts:
Today's most widely accepted definition of addiction -- used in psychiatry's latest edition of its diagnostic manual, the DSM-IV-TR -- recognizes that compulsive use of a substance despite negative consequences is key. And that's exactly what I experienced: At least six times, I made it through the physical sickness of heroin withdrawal -- the shaking, diarrhea and vomiting -- only to use again because I wanted the drug. This compulsive aspect helps explain why we can now consider video games and, yes, even potato chips more addictive than we did in the past.But the DSM retains a focus on physical aspects of addiction: It calls addiction "substance dependence," suggesting that physical need is critical. Tolerance and withdrawal are part of the criteria used to diagnose the condition, even though pain patients taking opioids as directed may experience both and not actually be addicted. Studies find that less than 1 percent of people who take pain medications and don't have a past history of drug problems become addicted. Many pain patients who stop opioids after the source of their pain has been removed even undergo withdrawal without realizing it: It's called "hospital flu." But the vast majority have no difficulty refusing further medication.
As a result, experts -- including NIDA director Nora Volkow -- have called for the official name of the disorder to be changed from "substance dependence" to "addiction" in the next edition of the DSM. They say the confusion between physical dependence and addiction leads to under-treatment of pain: Surveys find many patients, even those who are dying, don't receive enough medication for effective relief. Physicians are even criminally prosecuted for "over-prescribing" when patients with painful conditions become physically dependent on opioid drugs.
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That's a good point about undermedicating when there's physical pain involved. Many Dr.s are so concerned about the addiction versus what is theraputicaly nessesary that they almost discourage their patients from taking their pain meds at all. This just does'nt make sense to me, and it seems to be detrimental to their physical as well as their emotional well being. Like they have failed in some way because they gave in to pain and took their prescribed drugs. I don't get it!
I can't help but notice how the article used "substance dependence" and "physical dependence" for what is actually an addiction (period) to the stuff. When will the doctors stop sugar coating something that is a major issue in the world?
My father suffered from lung cancer and I had no problems with them medicating him to the point he became addicted to the stuff during the end of his life.
At the same time it is hard for a doctor to know how much is to much for someone suffering from chronic pain.
I believe the doctors that have the authority to write these prescriptions should be required to yearly attend a refresher course on prescriptions that cover the major medications that are regularly being prescribed.
Nancy a.k.a. sixlittlekitties
Anyone who reied/tries to take my Vicodin away from me had best be prepared to take on an extremely angry and fiesty redhead!!! My limbs might not all work, but I can weild my cane fairly well with the one working arm and the crook at one and can be used to catch someone when necessary! I face enough emotional/spiritual pain daily to willingly take on any more PHYSICAL pain than is absolutely unavopidable!
Margaret:
I don't want to take Vicodin away from you.
I want doctors to dispense it a lot more responsibly -- as, I hasten to add, I want Pdocs to dispense benzos and sleeping pills a lot more responsibly.
You INHERIT Bi-Polar (manic-depression) disease. It is not a disease when you choose to take heron or pain pills. You are addicted to what you put in your body. This disease, Bi-Polar, is in your brain when you are born and grows like cancer all your life until the big boom between 18 and 25yrs old. It's like cancer it grows and grows until you can't do anything except get treatment. I hate it when people say that a disease is addiction and Bi-polar is an illness. Baby, it's the other way around. People who have Bi-polar and have addiction are self-medicating with drug of choice because they want to either calm down, numb the pain, calm anxity, get a boost out of depression, slow down the racing thoughts, ect.
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