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Addiction - How do you Define It ?

St. Phatty

Active member
In 2004, I met a man named Dan, the ex-husband of a woman friend in San Diego.

Dan lives in Vancouver, and manages a large cooperative apartment building.

Dan lives in a wheelchair. He was paralyzed from the waist down in a car accident in the US.

Dan was unable to receive treatment for his pain, in the US. He tried to commit suicide. Fortunately, that was not successful.

In Canada, Dan's doctor gives him a prescription for Morphine, which he takes - every day.

During the 3 or 4 times we got together for dinner or just to smoke a doob, I could never tell that Dan was consuming morphine.

He had none of the Cheech & Chong-ness associated with morphine use - which may be a TV thing, a Hollywood illusion.

I could also never tell what time of day he took his daily dose or doses of morphine.

He was just clear-minded all the time, and had a happy life, under the circumstances.

His new ex-wife in Vancouver joined us for one dinner, and we walked & rolled around Vancouver.


Question - is Dan Addicted to Morphine ?

I think that basically, it doesn't matter - it depends on the definition of Addiction.

What matters is that he is as healthy as possible, under the circumstances.

And as productive as possible, because like many of us, what makes us feel good is getting work done.


I too live with chronic pain, 2 kinds since my tooth experience started on August 9.

I am taking Tapentadol for the tooth pain. Although 3 dentists are involved in causing or treating the tooth pain (hopefully soon to be 4, as I have asked the 75-year-old family dentist in San Diego to do a telephone consult. with me Thursday morning), none of them has given me an effective medication for treating pain.

Because it is a WHOLE LOT of pain, that is mind-boggling to me.

That leaves me buying the Tapentadol from a neighbor, on the free market.


I asked my brother in San Diego to help me. He is dealing with a transgender child who uses opiates for fun off and on.

So the brother is telling me that I'm a drug addict.

My answer is basically, So What ?

I work hard to be as healthy as I can, under the circumstances, like Dan in Vancouver ( if his legs worked.)

I did a tapered withdrawal from my preferred medication/ drug of choice Tramadol, which is both an opioid mimick and an SNRI anti-depressant, about 3 to 6 months ago.

Got down to nothing, spent 2 days taking no pain meds (except Cannabis), and then started taking the Tapentadol.

I think that both Tapentadol and Tramadol are very complex, powerful molecules, and should not be mixed.


I would like to see the General Public in the US effect changes - by the end of 2019 - so that Dan, if he so chose, could return to the US and, for example, manage an apartment building in Seattle - which would require that he have a doctor to prescribe morphine.
 

Lost in a SOG

GrassSnakeGenetics
The Russian Tsars were addicted to buying faberge eggs...

You might be a drug abuser but calling someone an addict is hypocritical as the very nature of neural plasticity basically means anything is an addiction so long as you get a regular dopamine release from doing it and go back for more.. could be gambling, World of Warcraft, Golf, fast cars, sex or cocaine its all an addiction.. in some ways some of these are more insideous and hard to forgive addictive agents than pain killers.. :2cents:
 

St. Phatty

Active member
The Russian Tsars were addicted to buying faberge eggs...

You might be a drug abuser but calling someone an addict is hypocritical as the very nature of neural plasticity basically means anything is an addiction so long as you get a regular dopamine release from doing it and go back for more.. could be gambling, World of Warcraft, Golf, fast cars, sex or cocaine its all an addiction.. in some ways some of these are more insideous and hard to forgive addictive agents than pain killers.. :2cents:

If I quote you in a written document, I will pay you by the word, for your contribution.

I don't mind if my brother wants to call me an addict - as long as I get treatment for the sources of the pain.

Well actually I do mind, but I can live with it.
 

Ringodoggie

Well-known member
Premium user
Dude, no tooth pain in the world lasts more than a few days. WTF? Go to a dentist and get the tooth fixed.

I have had terrible tooth problems over the years and it is definitely a very hard pain. However, a trip to the dentist always took care of it.

What kind of dental pain are you having that has lasted this long. You were posting about dental pain days (maybe weeks) ago.
 

Lost in a SOG

GrassSnakeGenetics
Some rotten teeth is one thing but root canal, implants and other really invasive work can cripple people for life through poisoning and nerve damage. Comes up a lot in my line of work.. It's amazing how much damage bad dentistry practices can actually do to the health of a person..
 

Douglas.Curtis

Autistic Diplomat in Training
Addiction is a single term used to describe two different situations.

The first is where a substance or activity brings relief to a known or unknown issue. Because of the relief, the substance or activity is repeated. When the issue is resolved through other means, the so called 'addiction' evaporates. In this case I would call the 'addiction' an indicator of unresolved issues.

The second is a chemical addiction where the body has adjusted to the presence of a substance and removing it causes pain through withdrawals. You will naturally seek out the substance to alleviate the pain, whether you're aware of the connection or not.

I consider relieving medical conditions with addictive drugs to be more of a life comfort maintenance type of thing, not an addiction. Sure, you're addicted to the chemical but you're also addicted to being functional. ;)
 

St. Phatty

Active member
Dude, no tooth pain in the world lasts more than a few days. WTF? Go to a dentist and get the tooth fixed.

I have had terrible tooth problems over the years and it is definitely a very hard pain. However, a trip to the dentist always took care of it.

What kind of dental pain are you having that has lasted this long. You were posting about dental pain days (maybe weeks) ago.

The appointment where things really went South was August 17.

I am still drinking Ensure (liquid food that doesn't require chewing) today, October 17.

I certainly wish it was otherwise.

I don't want to get the teeth pulled, because that will cause more pain, and I'm being forced to fend for myself pain med wise.

The root canal dentist has the ability to help me, but he is strictly by the book, and also failed to tell me the simple thing - IN ANY CASE, we would wait a few more weeks to see if the pain resolves.

I'm not asking for a root canal on the remaining 2 painful teeth today; my first root canal was October 9.

I would think basically, 2 to 3 weeks between appointments is a good pacing.

Yeah, it has been WAY TOO LONG. I know what the endodontist would do if it was his mouth - he'd have the source of pain removed, i.e. a root canal from another dentist.


I consider relieving medical conditions with addictive drugs to be more of a life comfort maintenance type of thing, not an addiction. Sure, you're addicted to the chemical but you're also addicted to being functional. ;)

One of my primary pleasures in life is getting Work done.
 

St. Phatty

Active member
Very interesting. I did a tapered withdrawal from Tramadol 4 to 6 months ago, and am now doing a tapered withdrawal from Valium, down from 10 mg a day to 2 mg.

Those are the 2 meds that help me live with chronic pain, and perform (on a good day) at anywhere from 4 cylinders to 8 cylinders (using a V8 engine as the example of a fulling functioning human.)

This massively interrupted my sleep.

I didn't get a full night of sleep for 6 months. Most nights, not more than an hour.

The last 2 nights ONLY, I have had REM sleep with DREAMS !!! :woohoo:

Yesterday Wednesday, my teeth felt incrementally better (less terribly painful and shitty).

This morning Thursday, again, incrementally better.

This is the first time I've had 2 days in a row when my teeth got better.

The connection to REM sleep is very interesting.

I knew that sleep is very important for your immune system.

Seems like it's very important for the teeth immune system.


The only reason I did a tapered withdrawal was, lack of access to medications. I still have about 70 Tramadol and 10 Diazepam, but knew I shouldn't keep taking them if I don't have access.

The re-scheduling of Tramadol and many other pain meds in January 2014 created a huge hunger for online pharmacies.

They were pretty sophisticated.

January 2018, something happened, related to shipment, or arrest, or something.

Now, 9 months later, they appear to have put some work-arounds in place.


If any of you are interested, I encourage you to work in the online pharmacy industry. It provides a huge service to Americans, given that American health care is so spotty, expensive, and unwilling to treat pain.

I'm pretty sure that some of the online pharmacies that operated from 2014 to 2017 got very wealthy, just living off a trickle of revenues from the American "health care" industry, probably less than 1% (of $800 Billion.)
 

Nirrity

Active member
medics differentiate addiction from dependence.

addiction is an irresistible craving to experience euphoric rush again and again if we speak about substance abuse. that's why roa matters here. smoked or injected drug creates rush which is absent if you go oral roa.

dependence is a physical need of a human body for a normal functioning in case of a drug abuse. there are not so many substances which cause physical dependence: opioids, benzodiazepines, barbitirates, ghb, alcohol and probably some others. cocaine or amphetamines do cause addiction but don't cause dependence. speaking of opioids, there is difference when people take painkillers to actually relieve pain and improve quality of their lives and probably developing dependence and addiction to a certain degree in a long term vs shooting painkillers to experience pleasure in the first place and developing addiction first and much dependence later on (dependance doesn't appear from the first shot, it actually takes a few months of abuse)
 
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To me, it's addiction when there's both a mental AND physical need for a substance or activity. When you only get physically ill after stopping, that's dependence (which is bad enough). But when a thing occupies your every waking thought & your every sleeping dream, that's addiction. When you do things you'd never dream of doing such as stealing, lying, forging prescriptions or pawning your mom's heirloom jewelry to get a fix, you're officially an addict. When you continue to engage in a behavior despite clear negative consequences on your life (financial, interpersonal, legal, economic, etc), that's addiction.



And yeah, literally anything that's enjoyable can be addictive. We all have our vices but some things are inherently more addictive than others. Stuff that releases unnatural amounts of dopamine or endorphins like meth or strong opioids would be high on the list, but only for people who enjoy them. Not everyone feels a void & responds positively to those drugs in the first place. For some folks, exercise or shopping or religion scratches the itch.



I've used low doses of opiates & stimulants for 14+ years now without escalating my dose or falling victim to any of the aforementioned pitfalls above. I view them as a treatment like my Prozac & can't afford for them to become ineffective or I'll be out of options which scares me more than addiction or withdrawal.
 

Iamnumber

Active member
_growbynumbers_sub_addiction PS if you quote this message, please remove this line

---

I did some research way back ..


I define addiction as something one can not go without too long ..
I also do exclude medication that one could stop taking but would die or risk death without. Extreme example is air ..



as for what is 'too long' .. There is no point of going without someting one likes for months just to prove someone that one is not addicted.



I arrived to three levels.. one, two and three weeks. Scoring on ' roughly no thoughts about XX ', Few thoughts; daily thoughts, several thouts a day; near constant thoughts - dificulties to focus on job at hand/ family etc. ; daily life is consumed by thinking about XX . and finally failure to stay away/ abstain from XX.

scale is not linear but logarithmic.. Failure to abstain is not 10 times as bad as thinking few times .. it is 100 times as bad.



so.. the amount XX occupies ones thouts or failure to abstains is the score of addiction level. The length is the level of confidence of the test - one is fairly reliable, two weeks is reliable and three weeks is very reliable.



With pain things get tricky. The key is that patient should be cared for (to get food, bathe etc.) .. length should be kept much shorter .. I would say 1/3 of what was stated above. This is due to deterioration of muscles and social connection and how pain affects one body and brain.



On the other hand.. pause from pain medication is a good thing for patient as tolerance buildup usually dissipates during this time.


This is for private use only.. use or quote in publications .. please contact me.
 
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St. Phatty

Active member
On the other hand.. pause from pain medication is a good thing for patient as tolerance buildup usually dissipates during this time.

This is for private use only.. use or quote in publications .. please contact me.

Hi, I'm from JAMA (Journal of the American Medical Association).

We'd like to quote you. Is that Mr. or Ms. Number, or Mr. or Ms. Iamnumber ?
 

Iamnumber

Active member
Hi, I'm from JAMA (Journal of the American Medical Association).

We'd like to quote you. Is that Mr. or Ms. Number, or Mr. or Ms. Iamnumber ?


What is the name of the publication and what format(s) are we talking about? paper daily newspaper? paper monthly special interests magazines? e-versions of paper media? blog? radio show ..


What is the name of article? and what is the core message of article?


What is the education/ professional level of readers? ( this has huge impact on wording used, disclaimers attached and how much methodology should be opened up )


As said.. my message was intended for private use to help users of this forum to gauge their relationship to activities/ substances.


I did my original research on tobacco and addiction to tobacco and nicotine. I specify these as separate entities as nicotine is not the sole addiction causing entity in standard tobacco. There is the social aspect and I found out from reliable traditional media outlet ( I did not write down the exact number of magazine - real shame ) that tobacco companies add substances that cause/ enhance addiction to tobacco. Original research was done by person fighting tobacco companies .. Since then I have had confirmation to this as I have asked many many cigar smokers (daily smokers up to 10 cigars a day .. and I am talking about mote cristo no4 or bigger .. not the tiny cigarillos).


So that was the history..


For pain medication and related issues .. I had to dig in and find out what I could due to personal issues. This includes finding out about how ssri and snri drugs along with other drugs that are not designed to medicate pain (epilepsy drugs for example).. are really pushed for patients with pain. .. in plaitant disregard to possible side effects .. AND that includes possible PERMANENT side effects. Patient is not adviced or warned about risk for these. (at least here this is the situation)



Also .. the patient is not helped (given tools to find out or spot) to diagnose possible side effects. These can be extremely tricky as they affect the mind and as they affect the mind the new state feels normal to the patient. The easy example is sexual desire and loss of it. As one takes drug and the loss is gradual .. so dose patients understanding what is normal for him/her sexual desire gradually change.. until it feels normal that one dose not have sex or masturbate in months .. one finds out the change (usually) only when one gets off the drug and once situation normalizes .. one looks back and ' that was not normal .. I masturbated XX times a week before and roughly the same now.. but I only did X times a month/year while I was taking the drug).


I also found out reliable seeming research papers on ssri/ snri drugs relationship to violent behavior and I heard reports that most/all shooters involved in major school shootings at time were actually taking ssri/snri. These were only heresay and I have not seen actual autopsy reports or other reliable source on this.



I have been interviewed couple of times for traditional media but I am a newbie riding on steep learning curve here. So at this point I would prefer NOT to be quoted. These messages are publicly available here. This might change as I get more info (see questions above) on what and where etc. You can post reply here or pm me.




Edit: and ..
* what would be exact quote..
* final draft review with "this is ok for me" / "this is not ok for me". (there has been some unscrubilous parties who have gained co-operation from parties (police dep.) by telling that story/ use is for DDD .. when final product came out the use was actualy RRR - that is to say totally different. Trust and verify..


forgetting this kind of key points is part of loss of cognitive functions that long term (years) pain can do to individual. and I almost edited my previous post ( more mistakes, less attentive .. )
 
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Brother Nature

Well-known member
Hey mate, you're not a drug addict by your brothers understanding of what that is. You've likely developed a dependence based upon what has been given to you, your rate of pain, and your rate of recovery. I'm utterly amazed that with the level of pain I've heard you speak of in this and other posts, they only gave you very mild opioids. Something like hydrocodone would be ideal for what you're experiencing and as far as I knew was the standard, perhaps the issues in the US with opiates has changed this? Tramadol is a terrible drug and I speak from experience. I had a severe motorcycle accident 3 years back and that was among the pain killers I was prescribed. I had more problems with that drug and the side effects than the morphine and oxy combined. Being an SNRI and synthetic opiate, it has seriously toxic reactions with a number of other drugs, Tapentadol is one. I seriously hope you can find a way to get your mouth looked at and get that sorted man. Once you've got that down, beating that dependence will be easy, as long as you're doing well, which it seems you are otherwise. I wish you luck man.
 

St. Phatty

Active member
Hey mate, you're not a drug addict by your brothers understanding of what that is. You've likely developed a dependence based upon what has been given to you, your rate of pain, and your rate of recovery. I'm utterly amazed that with the level of pain I've heard you speak of in this and other posts, they only gave you very mild opioids. Something like hydrocodone would be ideal for what you're experiencing and as far as I knew was the standard, perhaps the issues in the US with opiates has changed this? Tramadol is a terrible drug and I speak from experience. I had a severe motorcycle accident 3 years back and that was among the pain killers I was prescribed. I had more problems with that drug and the side effects than the morphine and oxy combined. Being an SNRI and synthetic opiate, it has seriously toxic reactions with a number of other drugs, Tapentadol is one. I seriously hope you can find a way to get your mouth looked at and get that sorted man. Once you've got that down, beating that dependence will be easy, as long as you're doing well, which it seems you are otherwise. I wish you luck man.

Thanks, though you may not like my recent solution.

I had 70x 100 mg Tramadol in the freezer, and maybe another 20 laying around in a box in the office.

Hadn't taken any in 4+ months. But I thought maybe I had been sufficiently stubborn about stepping away from it.

Started taking it again Sunday. Had an immediate healthy response, similar to when I first took it, though with 1/2 the dose.

In the afternoon, I guess I was physically tired, since I laid down and just laid there for about 1 1/2 hours. Sevasana - the corpse pose in Yoga - fancy wierd name for lying on your back. Super relaxed, like someone had turned up gravity.

Slept great Sunday night, with deep REM sleep, dreams, etc.

Mouth felt almost normal Sunday morning, not as great Monday, but a lot better.

Since Tramadol has an SNRI effect, I have to separate how I feel about the pain, from the pain itself. I can do that by lightly compressing my jaws together so that one of the problem teeth touches the teeth beneath it.

The sign-me-up-for-euthanasia pain is gone.

I conclude, I knocked my immune system for a loop when I went off Tramadol - another sign (maybe) of physical dependence. Directly related to lack of sleep.

I'm now more focussed on preparing the house & grounds for winter, so might wait another week to finish dentistry related letters.

ID'ed 3 or 4 academic dentists & dental faculties to write.

That means speaking dentist speak so it could take me a week to write the letter. Might even write one of the local "pain doctors" to point out - I'm trying to remove the source of the pain, that creates an appetite for pain-killers.

How far will I have to go to get the sore teeth removed via root canal? California ? Mexico ?

Also going to the clinic to ask for injections of antibiotics, so I don't have to roil my stomach with oral antibiotics. That makes it hard to sleep - which obviously impacts my immune system, including the immune system for the teeth.

My own success with Tramadol in no way contradicts other people's opposite results.

It should never be mixed with other synthetic opioids like Tapentadol.

Also, I weigh 180 pounds. So, .28 mg per pound of body weight, call it .30. Took .556 when I was younger.

I've talked to people who took more, and I am not surprised it was a problem. That's why I cut my dose in half, which I think is age-related.
 

Iamnumber

Active member
Bit more regarding pain and addiction..


When I spoke of pain before.. I did mean pain from OTHER than pain caused by withdrawal symptoms.


As we are now moving to area where getting reliable data is very difficult.. this is much more speculation based on circumstantial evidence.


The danger is that as one medicates the pain ( not enough detailed info on how this happens to people who get addicted ) .. body/ mind gets addicted to the medicine .. as things progress .. it is feasible to speculate that patient might not distinguish between original pain and pain caused by withdrawal.


What I have gathered from various sources .. Huge part of addiction comes from people who use medication in other ways / amounts than prescribed.


Second is the over medication .. My guideline is that getting ability to function is primary and crucial goal (functionality with some pain). Removing all / all most all pain is secondary goal .. and this is where things will get tricky.. I have trouble getting primary goal so it is very easy for me to say that some pain is good.. well.. i would prefer to have almost no pain .. but I do acnowledge that risk of getting addicted will increase. (due to risk of over medication.. see next) .. and finally the feeling of euphoria.. I guess this is a risk even when medication is for an injury and medication is taken as and as much as prescribed. Now we are in really dangerous situation.


proving that pain is from legitimate ailment rather than from withdrawal is nearly impossible .. what I wrote above is my best solution to the issue BUT .. one who has made up ones mind that patient is addicted will just say that 'that's from withdrawal pain you poor junkie'



Again the only solution to this is to have doctor (when you get diagnosis etc. before medication) write down how you describe your pain (location, what it feels like, how intense it is (numbers of how it affects your ability to move)) etc. Be polite as doctors (here at least can be .. hmm.. no nice way to put it.. not too happy about patients challenging their authority and .. i guess .. wishing to experience the power trip .. maby they are addicted to it :laughing:) .. so ' would it be possible to add these things to the text you write down? If not then 'Why not?'
 

St. Phatty

Active member
Again the only solution to this is to have doctor (when you get diagnosis etc. before medication) write down how you describe your pain (location, what it feels like, how intense it is (numbers of how it affects your ability to move)) etc. Be polite as doctors (here at least can be .. hmm.. no nice way to put it.. not too happy about patients challenging their authority and .. i guess .. wishing to experience the power trip .. maby they are addicted to it :laughing:) .. so ' would it be possible to add these things to the text you write down? If not then 'Why not?'

Yes, most doctors are assholes. But it's better not to raise your voice or to use foul language during a "medical" appointment.

"text you write down" - you mean when you fill out forms before an appointment ?
 

yardgrazer

Active member
Take it from someone related to a doctor - there are a lot of drug seeking patients out there, and what happens to them is on the doctor's medical license. Opiates are not safe. A good doctor should be encouraging most patient's to try to ween themselves off dependence on opiate/opioid painkillers. On the other hand, they also should be trying to put aside any resentment they feel about the drug-seekers and do what they can to help people with longterm pain problems. Our current insurance system pushes doctors to get 'em in and get 'em out.


As for how does one define addiction? Obviously it involves dependence, but true addiction usually involves a user who wants to stop, but can't.
 

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