Pseudoaddiction – More Info For The Painies


This article is not a substitute for medical advice. Consult your physician for and any and all questions/concerns regarding your medication and care.

 Introduction:

Recently I read an article about Pseudo Addiction and Chronic Pain Patients. This information should be helpful for those who suffer the stigma and prejudice drawn from using pain medication. Regularly, Painies are seen as Junkies and/or Drug Addicts. Medical Professionals are hesitant to prescribe; while friends and family are afraid of medications.

 Sometimes, the “Painie” may exhibit behaviours that are of concern. They may be anxious about renewals, dosages and access to Doctors. However, it seems that because Pain Patients may not have the appropriate dosage or access to care, they may exhibit behaviour that may be misconstrued as the actions of a True Addict. The questionable actions go away; once the patient is properly medicated or the pain goes away.

 To provide an understanding for both the Painie and their community, let’s look at the difference between a “True Addict” and a “Pseudo Addict”.

 True Addiction

Drug addiction is an extremely serious condition. Here is an excerpt from the Mayo Clinic explaining the definition of True Addiction is and some behaviours’. To provide a fuller understanding of Addiction, please click on the additional links.

 “Definition:

By: Mayo Clinic Staff

 Drug addiction is a dependence o a street drug or a medication. When you’re addicted, you may not be able to control your drug use and you may continue using the drug despite the harm it causes. Drug addiction can cause and intense craving for the drug. You may want to quit, but most people find they can’t do it on their own.

 Not everyone who uses drugs becomes addicted, but for many what starts as casual use leads to drug addiction. Drug addiction can cause serious long term consequences, including problems with physical and mental health, relationships, employment and the law.

 Drug Addiction Symptoms or behaviours Include:

  • Feeling that you have to use the drug regularly – this can be daily or even several times a day
  • Failing in your attempts to stop using the drug
  • Making certain that you maintain a supply of the drug
  • Spending money on the drug even though you can’t afford it
  • Doing things to obtain the drug that you normally wouldn’t do, such as stealing
  • Feeling that you need the drug to deal with your problems
  • Driving or doing other risky activities when you’re under the influence of the drug
  • Focusing more and more time and energy on getting and using the drug. “

 Source: http://www.mayoclinic.com/health/drug-addiction/DS00183/DSECTION=symptoms

 You can see the person with a True Addiction would go anywhere and do anything in order to get the drug of choice; criminal behaviour included. Their use of the drug is with complete disregard to their own health and social situation. Loss of family, house, job or friends will not stop their use of the drug.

  Pseudo Addiction

 While some of the behaviours may mimic true Addiction; it is not the same. The salient difference is once the pain stops – so does the behaviour. With a Pseudo Addict – it is usually a case of the chronic pain not being properly treated with medication. psychological factors like fear of pain and/or anxiety about being able to access medication to stop the pain.

 With Pseudo Addiction, the patient may be concerned about the following:

  • When the next dose can be taken
  • When a refill or renewal of a prescription can be completed.
  • If the patient has access to painkillers – i.e. a Dr. or clinic
  • Anxiety about medications – and may seem like obsessive behaviour
  • Constant discussion about pain medication
  • Increased dosages of pain medication.

 This issue is crucial to understand, because it is one of the biggest reasons Painies are isolated. It is beyond me, why people are so judgemental and assuming. Who wouldn’t want the pain to stop? Wouldn’t anyone be afraid if they knew pain was coming and they couldn’t stop it?

 It is unreasonable for anyone to suffer. The medication is there for a reason and because we are in pain, doesn’t mean we should feel it all the time.

 Here are some links that will flesh out Pseudo Addiction further:

http://pointsadhsblog.wordpress.com/2011/04/27/addiction-and-pseudoaddiction/

http://www2.massgeneral.org/painrelief/Pain%20Topics/What%20is%20Pseudoaddiction.pdf

http://www.addictionmanagement.org/Pseudoaddiction%20versus%20Addiction%20in%20a%20Pain%20Population.pdf

http://pointsadhsblog.wordpress.com/2011/04/27/addiction-and-pseudoaddiction/

 Story Example:

For those who have to deal with explaining what it is like to require pain medication, this example may be helpful. Just tell them this story and maybe they may have some empathy.

“Imagine your bare hand 1 inch above a burning flame. You are not allowed to know when you can take it away. You are not allowed to know if the flame will get higher, bigger or hotter. You can’t move your arm, shoulder or any other part of your body. After about an hour you will start to feel pain in your neck, shoulders, arms and hand. You might experience, burning, tingling, numbness, throbbing pain, piercing pain and/or a deep ache. Nope, you can’t move yet. Starting to feel the anxiety? Starting to question when can this stop? How will it stop? What can I do to make it stop?

Now move on to hour 2 – the deep throws of the pain. You may feel tired, sleepy and/or exhausted. You might feel nausea, sickness, headaches and/or pain in your chest. You may start to feel like you are sweating all over. The pain in your body probably has done an arch – where you stopped feeling the pain for a period of time; that is your endorphins – but wait until hour 3. Emotionally you have probably felt some relief; thinking “this isn’t so bad”, but wait your body has a way of tricking you.

Hour 3 – the pain is back – your body has burned out it resources and now you have to stay there. You are starting to feel desperate – starting to say in your head over and over “Make it stop, make it stop.” You have probably started to use coping strategies like distraction and meditation. When talking to people now – you probably have lost your train of thought – can’t remember words or phrases. You may feel like you are talking to someone – but the pain has somehow encapsulated you and you feel like you are someone else.

After Hour 4 – wouldn’t you do anything to take away the pain – even for a minute? Now you are allowed to take your hand away. I bet you have passed out, rubbed your hand, cried, put salve on your hands and anything and everything you could to make yourself feel better. Now imagine someone saying “Just kidding back you go?”

Imagine that every day – 24 hours a day – 7 days a week. Not knowing when the pain will break, for how long or if ever. Never understanding why it happens and how? Knowing it could come back at anytime. How do you stop it?”

Conclusion:

 Pain medication is not the only answer to pain management. Yet, using it shouldn’t make the patient feel ashamed, judged and weak. It may look scary to the Dr., family, friends, colleagues and co-workers when a Painie is desperate to ensure access to medication. It is frightening to watch someone you love, be counting down the days to a renewal. However, the behaviour must be understood by everyone.

 Of all the Painies I know, not one of them is happy about taking the medication. Nor do they feel a Euphoria or “High” sensation when taking the meds. They simply feel some relief from the pain. Why should we not be able to stop the pain? A greater understanding about Pain, Medication and our State of Mind is very important.

 I encourage my readers to go to the links I have provided and/or find some more resources. Discuss these issues with your Physician, your family and friends. Open and honest communication about your Pain Management Strategy will help all of us. Sharing this article and the ones linked would be a great start.

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9 thoughts on “Pseudoaddiction – More Info For The Painies

  1. You raise very important points about the difference between addiction and psuedoaddication.
    Also of consideration is physical dependence versus addiction. Like an addict, a “painie” may go through physical withdrawal when a drug is stopped “cold turkey,” of the dose is reduced.
    Having experienced withdrawal, I know that it’s no fun, and you want the withdrawal symptoms (as well as the pain you are perhaps now experiencing with little or no pain medication for pain relief) to stop.
    But, it’s a physical dependence — once the withdrawal symptoms have either been tamped down or lessened with time, a painie doesn’t “need” the drug. Again, from experience, I might wish I was on the medication again if the substitute med doesn’t help as much with the pain.
    An addiction is being psychologically as well as physically addicted to the drug, and therefore, an addict can continue to crave the drug even after the withdrawal symptoms are gone.
    In simple terms, as you suggest, an addict is looking for a high (which might reduce/eliminate any pain they are feeling), but a painie is just looking for relief from the pain.
    Thanks for so carefully delinating addiction versus psueoaddiction. I plan on visiting the links you have provided. Folks may want to show this to friends, family, and health care professionals who don’t understand the difference, and see only the name of the medication: oxycontin, morphine, etc., rather than trying to understand the relationship of the painie to pain and pain medications.
    (I’m very foggy-groggy as I write this, so I know my spelling, grammmar, and logic is probably off. Hope it makes some sense! 😉

    1. Thank you Phylor. I agree that there also is the issue of “dependance” or being dependant on the drug because it gives the “painie” quality of life. Not a high – but the basic ability to walk, talk etc. and be part of the greater landscape.
      Of all the folks I know who have gone off the pain meds – it isn’t the withdrawal they fear – but the pain.
      I hope you are feeling ok today!

    2. I’m a chronic “painie” & EVERYTHING I’ve been reading here, inlcuding YOUR comments were, without a doubt, a breath of fresh air to me. I’ve felt SO alone, for SUCH a LONG time, dealing with my pain & the misunderstandings of loved ones & friends (their concern with MY “Addiction” to Oxycontin). But the truth is that I barely have my pain managed anymore. My doctor raised my dosage about every 6 months to a year till about a year ago. Since then, he simply doesn’t talk with me about it. When I try he makes me feel guilty for bringing it up. And now there’s this new “Oxyneo”. So.. I’ve been living with pain, DAILY, for a very long time now. So, WHY is it that, here in Canada, Shoppers Drug Mart, one of the largest pharma’s in the country, has been stocking up on OxyCONTIN for a while now. For “certain” patients who don’t tollerate the new OxyNEO, and who get specific perscriptions from their Dr.’s for OxyCONTIN!!! WHAT does Shoppers Drug Mart know? Thank you for your comments & this website too. I’ll also be checking out the links. Take care & hope others find & share this site too…

      1. Hi Tara, Thank you for your comments. I am sorry that you are feeling so, how do I say it, desperate? sad? discouraged? about your pain management.

        My suggestion, is to find a new doctor maybe? Please click on the link to The Canadian Centre For Integrative Medicine. Also, maybe talk to your Dr. about using another pain medication. **I AM NOT A DOCTOR AND AM NOT ADVOCATING NARCOTIC USE OR ANY TYPE OF MEDICATION** but your Physician may be able to put you or try you on something else.

        I also truly recommend trying a Naturopath and/or if you can afford it, trying a place like MedCan. You can get a full workup in 1 day. I mean EVERYTHING, eye exam, blood tests, ultrasounds, scans, X-rays, stress test, fitness assessment, nutrition assessment, etc. etc. This was the place that I was able to get a ton of info on my system in one place, instead of waitlising and fighting Dr.s to get these tests done. It has and was extremely helpful in getting me on a path of recovery – after 8 years. They didn’t cure me – but armed me with the ammo to fight the pain.

        I am happy this website has been helpful and I hope that it continues to be. You are not alone and there, sadly, are many of us out here. Although, Canada has universal healthcare – Painies have to pay for almost 90% of what we require – unless it is easily diagnosed and treated – we have to get to a place where the WHOLE patient is treated not just one facet of the illness. That is how I got so sick – one Dr. then another specialist – another drug – another MRI another “We don’t know”, finally with the Naturopath I have found some recovery and an end to the disintegration of my body. Just remember that you aren’t crazy, insane, needy, depressed, inventive or just supposed to “deal” – you are worth healing and you can get healed – it just takes 20 times the work of other more recognized and universally supported illnesses – like cancer or aids. However, if we keep voicing our needs – we can get there.

        Wishing you a pain free day.

  2. Thank you for writing this. The current climate of suspicion makes it so difficult to be a pain patient.

    I read somewhere (no idea where) a simple way to tell the difference between an addict and a pain patient.

    – An addict’s life gets worse because of the drug.
    – A pain patient’s life gets better because of the drug.

    I try not to worry about what the future holds for pain treatment, but sometimes I worry anyway.

    Anyway, thanks again! ❤

  3. Thank you for writing this. I have been labeled a drug addict in many different hospitals (moved cities due to being military) because of “drug seeking behaviors”. When, in fact, I was pain relief seeking. It has taken about 10 years to figure out I was not having kidney stone pain (even though I do have those too) but rather nerve pain issues from my gallbladder removal surgery 15 years ago.

    The pain finally got so bad about 9 months ago that it exploded and I ended up in my local ER with a doctor who thought I was an addict because I came in while pregnant with kidney stone pain (had those too) and he treated me like an addict. My pain was so bad that it w as s causing contractions at 20 weeks. And instead of treating me, he kicked me out. I had a good OB that treated my pain because he saw that my pain was trying to kick me into labor. He said it was better to have a baby who was dependent than a micro preemie.

    And after I delivered, my son and I got off the meds. Until September. And I got to see that horrible ER doc again. I even had him written up 3 times but he still kept treating me like an addict. By this time, I had gone in to see a Pain Management doctor. He happened to guess my pain was nerve pain. He put me on Neurontin and I haven’t looked twice at narcotics.

    I know I am not an addict because I had a friend who is one and she stole my narcotics from me (my leftovers). All I ever wanted was to not be in pain. My body may be addicted but my mind never had been. And while narcotics have their “fun”, their side effects of nausea/vomiting, itching, heartburn, and constipation make it too horrible for me to enjoy them.

    1. It is remarkable what we have to endure. I still deal with the prejudice and discrimination from Dr.s. I will be following up on this article based on a new protocol I am doing.
      Thank you for your comments and I am truly sorry that you had to endure not only the pain, but the humiliation of seeking an end to it. It seems that the Dr.s are so consumed with their licensing issues and not enough on appropriate patient care.
      I am sure though that the baby was a salve to some of the pain. I know my two girls are!!!

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