Pain is a poorly understood condition.
Many health care providers do not treat even acute pain adequately.
Managing chronic pain is much more challenging than treating acute pain.
Addiction vs. Physical Dependence on Narcotics
Many people mistakenly believe that if you use controlled substances, such as narcotic medication, you will automatically become an addict.
What are narcotics?
There are many names for these controlled medications, such as narcotics, opioids, and Schedule II. There are many medications that fall into this category: Percocet, Vicodin, Fentanyl, codiene, Oxycontin, Dilaudid, morphine, and the list goes on.
These medications are all a little different, but they all have one thing in common: they are morphine derivatives. This means they were all created from morphine and have similar properties and effects to morphine.
Properties of morphine: reduced pain, reduced depth and frequency of breathng, euphoria (feeling happy), pupil constriction, reduced movement in the bowel, physical dependency with prolonged use, and others. All of these effects are related to effects on or suppression of the central nervous system in the brain.
Your body produces its own morphine-like substances, called endorphins. These substances got their name by shortening the words “endogenous morphines” (endogenous means that is is made within the body).
Physical dependence to opioids means that the body relies on a external source of opioids to prevent withdrawal. Physical dependence is easily managed with medication, and is predictable. This dependence is resolved by slowly tapering the person off from the medication (lowering the dose by small amounts over specified periods of time).
As the pain patient takes the opioid medication, their body becomes used to the dose, and may require more medication to obtain the same level of pain relief. Some people do not develop this tolerance, but can be maintained on the same dose for long periods.If the medication is stopped suddenly, the body reacts to the sudden change by having withdrawal symptoms.
Physical dependence on opioids is normal and expected with prolonged use, and is not considered a disease state. Physical dependence can occur without addiction.
Many who are reading this post may have physical dependence on a substance without being aware. If you regularly ingest caffiene, and get a headache and irritability if you don’t get your morning cuppa, you are experiencing withdrawal symptoms due to physical dependence on caffiene. Sugar, nicotine in cigarettes, antidepressants and many other substances can also cause physical dependence.(1)
Addiction, now called opioid use disorder, is not normal and is classified as a disease. In addiction, the biology of the brain is altered. Addiction can occur without physical dependence.
The hallmark symptom of addiction is cravings. The cravings are out of control and lead to destructive behaviors, such as lying, stealing, inability to control their compulsive use of the drug, and continued drug use despite the harm done to themselves and others.
Recovery is possible, and is focused on reversing the altered brain biology, therapy, and learning healthy alternative behaviors. (1)
Myths About Pain
Which of the following myths about pain are actually true?
Myth 1: The person in pain has control over their pain.
Myth 2: Medications are the only truly effective treatment for pain.
Myth 3: If you use opioid medications for pain, the chances are high that you will become addicted.
Myth 4: If a person looks fine, they are not experiencing pain.
Myth 5: You can judge a person’s level of pain as well as they can, just by looking closely for clues, like facial expressions and body movements.
Myth 6: Exercise will worsen pain in the long run.
Myth 7: Most people who say they have pain are exaggerating it just to get attention and sympathy from other people.
Myth 8: People with pain should push themselves in order to get things done.
Myth 9: People who have experienced acute, short term pain can understand what it is like to have chronic, long term pain.
Myth 10: Caregivers to people who have chronic pain do not experience depression or need breaks from caregiving, since they are not the ones with chronic pain.
You should have guessed by now, that every single one of these is FALSE.