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”.
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.
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. “
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.
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:
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?”
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.