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Wednesday, July 25, 2007

Got Dilaudid?

A couple of weeks ago I started having nightmares that I was addicted to Dilaudid, so I spent several days trying to resist taking it. I didn't get the shakes, I didn't get nauseous, I didn't get addled or demanding, I just felt like I was wallowing in pain. It wasn't sharp pain, it was constant, never-ending waves of discomfort. I lost sleep and felt miserable.

I talked with friend and sister M about it - she's eminently sensible, reasonable and easy to talk to. She seemed surprised that I was worried: "Your doctor trusts you to be sensible about your use, and of all the people I know you're about the least likely to be a substance abuser." She told me to get out there and educate myself, and for heaven's sake to use the drug when I needed it!

I started looking and came to the following conclusions:
If one takes opiates for pain and takes them as directed, one may develop a physical dependency, but medical experts recognize compliance as a key indicator that one is NOT an addict.
Physical dependency is different from addiction, but today's social climate can easily lead one to equate ANY use with abuse.
Patients are generally willing to label themselves abusers, and will stop taking their medications despite their doctors' assurances that they will come to no harm if following directions. By not taking their medications they suffer needlessly.

There are several excellent sites available on this topic:
American Pain Society's Advocacy statement, "The Use of Opioids for the Treatment of Chronic Pain" addresses the social and legal aspects
US Food and Drug Administration's Consumer magazine, "Managing Chronic Pain" gives a good overview of the overall discussion
WebMD "Pain medication addiction and tolerance" gives general guideines for discussion and action

I talked it over with Dr G in Cleveland and he's not concerned with my continued use of Dilaudid. I'm taking it when I need it and I never exceed the prescribed dosage. I guess I have to trust myself. All things must be taken on balance:

"Every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism." - Carl Jung (1875–1961)

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  • You know how i feel about taking "controlled substances" as they are called here and addiction. I am physically addicted which I know only when I forget to take it (non compliance!) when I get multiple symptoms but from which drug? If you have pain that needs treatment, take the drugs; it's that simple to me.

    By Blogger Swanknitter, at 4:04 AM  

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