Breaking Stigmas: Dependence vs Addiction

Breaking Stigmas: Dependence vs Addiction

“So what changed?” My friend asks, flabbergasted. “You’re up, wearing makeup, out of bed, walking around, acting like you’re feeling fine!”

“That’s because I am feeling mostly fine, or much better than I used to.” I say and I proceed to tell her my story.

It’s a story I’ve told, in some form, many times in the last three years, for two reasons. One, I’m alarmingly frank about my life, which is why you get this article, and two, the change my friends saw in me was so immediate, so cataclysmic, so life-altering that they couldn’t help but ask.

Three years ago I was in a mental hospital after suicidal tendencies, on 8-10 different medications, none of which were working, completely drained emotionally, mentally, and physically, and in mind-numbing, nerve-wracking, anxiety-inducing pain 24-hours a day. I spent my days clinging to my parents, scared to be left alone, unwilling to leave the house, and in bed 24 hours a day. My life was in absolute shambles, and it was because of pain. Pain, that monster that won’t even let you get peaceful sleep at night, had completely taken over my life.

I spent two different weeks at inpatient clinics for my mental health, over a month at specialist hospitals for my pain, and untold hours curled up in my bed, crying my eyes out, just begging for someone to please, PLEASE, take it away. I was in the ER at least twice a month for pain relief because I couldn’t manage it at home. During this time I was being taken care of by my parents, thankfully, or I truly think I would have ended my life.

I was in mandated therapy and during this time one of my psychiatrists asked me why I’d never stayed on narcotics when they helped me so much. Her question surprised me. I knew that narcotics helped me, but I was ashamed of that. I believed that narcotics were unequivocally bad, and I didn’t want my doctors to think I was any less of a person than they already did. I was already their hardest patient to deal with. To add a narcotic addiction to it was unthinkable. The few times I’d been temporarily on narcotics I’d gotten off of them as quickly as possible so that I wouldn’t get addicted. On top of that, my neurologist was absolutely against narcotics; her fists curled up into little balls and her shoulders tensed up when she talked about it she hated it so much, so I knew they were off-limits. Why had I never stayed on narcotics? Because I had been taught that narcotics were bad and there was no good way to take them.

Then she said something that blew my mind. She said “you know, in the pain psychology community, we look at it differently. We say that addiction is when someone uses or does something, like alcohol or porn or gaming, to the detriment of their health and functioning. Dependence is when someone requires something to function better. If you started narcotics and they helped you actually function and live a normal life, we wouldn’t consider you addicted. We’d consider you dependent.”

Mind. Blown.

I thought about almost nothing else for a few weeks and then I made the decision that changed my life.

I’d rather live a short life than endure a long one.

I’d rather put pills inside my body that messed with my organs than continue on as I was: visiting the ER twice a month, fighting against suicide, needing to be taken care of by my parents, never seeing friends or holding a job.

You see, my life as I was enduring it then was not worth living. I hated it. I was miserable. I had tried over 100 non-narcotic medications to manage the pain and the side-effects were horrifying, plus they hadn’t worked. My mental health was frayed to the point of disintegrating, and my poor family was completely occupied in taking care of me, unable to live their own lives. I was alive, but just barely.

And so, with the approval of my psychiatrist, I made an appointment with a pain management doctor. He took a long look at my file and then saw me twice before he offered me a contract. I read it carefully and promised to follow every rule. Then I signed and he handed me a piece of paper that was my ticket to freedom and functionality. And that’s what it was: the narcotics made me functional. 

I should also add that I’m not ONLY using narcotics to treat my issues. I have a well-rounded regimen of healthy diet, lifestyle, treatments from both Western and Eastern medicine, and essential oils that I use. All of them together make me a whole, functioning person. I’m not wholly reliant on the narcotics, even though I am physically dependent on them.

It’s extremely important to say that I am careful to take the meds exactly as prescribed, never a minute before I am allowed to take them or more than I am allowed to, and to keep careful track of my meds so I don’t lose any. I do not lie about how much I’ve taken or ask my doctor for more than I need. When I go to the ER, which is rare now, I bring my contract with me or tell them about it so they know. My doctor has commented multiple times that I am taking them exactly as I’m supposed to and he’s not worried at all about me becoming addicted. I don’t show any signs of addiction, but I am clearly physically dependent on the meds. When I go off of them my body goes into withdrawal.

The difference between dependence and addiction is important. According to The American Pain Society in their document “Definitions Related to the Use of Opioids for the Treatment of Pain” most pain patients treated with opioids, while likely to become physically dependent and tolerant of opioid medications, will not become addicted. Their definition of addiction is “a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.” and their definition of dependence is “a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.” 

It is a tough thing to talk about, narcotic dependence and addiction, and in the world of Spoonies many people have strong feelings about it one way or another. My experiences may not be the same as someone else’s, and while I don’t personally struggle with addiction, I would never want to advocate for someone to start narcotics and become addicted to them. This blog is only about my experiences with being freed from the stigma of narcotics, and thus freed from the pain that has plagued me for years. I wanted to share how I was freed of the fear that taking narcotics would be worse than suffering through what I was going through. I also want to break the stigma that narcotics can’t be taken responsibly. My doctors will testify that I am someone who has taken them responsibly for three years, and I know of a few others who are doing the same. I also know of at least one person who is taking them irresponsibly, so I am not blind to the problems of addiction. I’m just saying I’m a girl who was nearly dead with misery before I was taking them and they have given me my life back. They aren’t all bad for everyone, and I feel like I should testify to that.

I refuse to be ashamed of needing narcotics to function. Narcotics, along with the love of my family, saved my life. With their help I am living life rather than enduring it

Within six months of taking narcotics on a daily regimen I had a job, I was living in my own place, I had a social life, I was volunteering at church again, my depression was under control, and I was happy.

I. Was. Happy.

The pills do not make my life pain free. I still have bad days, but they are not every day like they were before. In the hours that I’m not on the meds, I’m just as bad as usual, so I just cram my day into the time that I’m on the pills (because I don’t get enough to get me through a whole day). But the important thing is that they mask the pain enough for me to function. They masked the pain that I’d been spending 13 years trying to conquer, and that is splendid. That is amazing. That is more than enough.

***If you or a loved one is struggling with addiction, as opposed to physical dependence, please get help today. One hotline number is 1-877-769-0445. It is toll free.***

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