Is painkiller addiction/dependence ALWAYS wrong?

[Worrysaboutalot]

With the following caveats :-

: The person is a fully functioning adult person with reasonable mental health and able to make long term decisions.

: The person had one (or several) chronic conditions which are extremely painful and life long with no chance of pain ever ceasing.

:The painkillers have been prescribed by a consultant or GP who has all the medical record information and is monitoring the patient regularly.

:The person has been told they will be on these medicines life long.

I ask because I have several medicines, two of which are controlled and can be addicted. I can only have a month or less medication at a time, because of the risk of addiction. One of the pills I use for breakthrough pain, requires a GP appointment to discuss its use.

But despite all the 'it is addictive' concerns, yet I have been told I will be on this medicines for the next 30/40 years aka the rest of my life.

If I will be on these pills for the rest of my life, why the concern I will become addicted to them?

AIBU to not understand why I have to have the same facts repeated to me every few weeks, when this treatment is life long?

It does worry me. I don't want to get addicted to medicine but I can't live with the chronic pain, I was in before them.

There are many women on this site who have similar concerns, many who have to jump hoops and practical beg for the pain relief they need.

I am not sure of the answer really.

@DopesickSis that's awful and sounds like she could be abusing her meds to get high. Do you think it's deliberate or accidental? Since she wants to avoid a medication review it sounds worrying. No wonder you're stressed . Could you speak/write to her GP and tell them what you're aware of?

Thanks @EllieLucy is has been a difficult few days.

She a very straight-laced ex school teacher and would be horrified at the suggestion she was abusing her meds. However, she has been on them in increasing doses for such a long time now that I do think she has learned a set of behaviours that enable her to get the effect she now expects/needs from her meds.

She is barely eating these days. I have to ring her each day and encourage her to eat something. She has lost quite a bit of weight as a result and I think this is another factor that is impacting the effect of the drugs in her system.

She looks really pallid/grey in the face and a new symptom as of this week is hair loss. I feel she is spiralling down increasingly fast.

We (her adult son and I) have spoken to one of the GPs from her practice today (not her GP who she likes but I feel has just facilitated this addiction) and he has agreed a meds review and multi-disciplinary assessment is needed. We have also spoken to the manager at the care home and agreed that staff will take a more active role in ensuring that she is taking her meds at the correct times and that she is eating at least one proper meal each day.

Sorry to offload and derail the thread- not many people I can talk to about this

Sorry to hear about your sister @DopesickSis 💐💐❤️ what are the conditions that’s caused her to be on such strong painkillers in the first place?

I’m asking because my mum was like this due to painkillers for copd, bowel cancer and Crohn’s disease. Unfortunately towards the end of her life it was a real balancing act between being “here” and present as such and being in pain. Eventually being out of it won because the alternative was so awful. I suppose what I’m trying to get at is whether any of the conditions are treatable or changeable or whether infact this may be now as good as it gets…? I’m not sure there’s any straightforward answers. I can appreciate what a horrible and difficult situation you’re in.

My Mum used to stockpile meds (liquid morphine and Tramadol) - she’d request more than she needed and save it up and then knock herself out with it all. She would also traipse round the local pharmacies and stock up on Cocodamol. She used to ask me to get her some as well or ask for mine (obviously I refused). She had real issues but it was coming from a place of desperation because her health issues were so awful and so debilitating and nothing else worked, and I can relate to that myself.

It’s a very hard situation to be a part of.

@DopesickSis I don't know what help I can be but if you need a listening ear my PM's are always open

In the past, I had what I now realise was a codeine addiction. It was prescribed for a back problem and the doctor gave me a year's supply at a time, despite it being recommended to take for no more than 3 days in a row.

I'd say it is always wrong because, although the medicine was prescribed for a real issue, I couldn't control it and it could have killed me.

Taking codeine became almost like my hobby - I'd look forward to getting home from work and taking some codeine, or I'd take a day off work for my back problem but really it was because I didn't want to wait until I got home to take codeine. I didn't have a social life because just wanted to get into bed and take some codeine, etc.

I didn't take it at work, held down my job, and largely hid the addiction but as you can see, it was a problem.

It was only by moving to a country where codeine is not allowed that I overcame it otherwise I'm sure I'd still struggle.

Also, since moving I've managed the back problem without painkillers and now no longer struggle with it; I can't speak of your health struggle but personally, I can't help but feel that prescribing a bunch of strong painkillers wad just the easiest option for the GP who didn't even really make any effort to get to the root cause of the problem.

I should add, I first took it for just 1 week at a time - that's when I started to struggle with it (I didn't take it constantly, only when the pain was bad) but just these weeks turned into an addiction which led to me taking it every day even when pain-free. So please be careful

Well yes because if you get properly addicted your tolerance will reduce and you'll want to take more which is likely to be damaging in many ways. People have their lives ruined through addiction and most of them don't have a doctor who gives a s* there is no support out there so as annoying as it is to have the regular checks and warnings be pleased that you're getting them. Psychologically it makes a difference, addiction is an illness which will exploit a change in message and approach so it makes sense that your doctor is careful.

I’m in chronic pain too, I take 4 dihydrocodeine a day so not at maximum dose, if I don’t take them my pain is unbearable. I get 14 days supply at a time which is a right pain in itself.

As long as you are taking medication which is equal to or less that the pain you are in - no problem
If you are taking medication above what you need - problem
If you are hording and bingeing - problem

I Take life long v strong and on the face of it addictive painkillers. Without them I would have no quality of life
When things are better, with lots of rest or on holiday, I can massively reduce the painkillers or stop them to no ill effect and did so on holiday last yr and yr before

No one care about dependence on insulin etc if it supports life or any qua of life - as mine is with chronic pain

@DopesickSis

I hear your pain and love for your sister. Such a difficult situation for you to manage. I hope your sister gets a medical review soon and that helps her wake easier in the mornings.

I read that your sister already has her medicines pre-sorted in a blister pack for her, which means she is only taking what has been prescribed for her. You mentioned concerns about when she is taking her pills.

I have a Fitbit watch which sounds a vibrating alarm at set intervals over a day. I have 7 different times set. When my alarm goes, I take my pills, have a glass of water and go to the bathroom.

Maybe something like that might help your sister

It's fine to take medication when there is a medical need for it. A person with unrestricted morphine usage during end of life care is a different kettle of fish to someone taking it recreationally with no need other than their desire or addiction.

If the doctors are fine with you taking something it is because you are better off with the substance than without it. Most/all medication has side effects, my medication causes weight gain for example, but that side effect is less damaging than me not taking it is.

Just a few points.
I only take medication as prescribed, I do not get high off it, just a reduction in my pain levels.

I would counter argue that anyone who has learnt to cope with out painkillers, experienced a moderate and/or temporary pain. Those who experience permanent acute long term chronic pain understand the difference.

A chronic pain is unbearable without painkillers. I can say that this nerve pain is far worse than my four labours and my infected gall bladder post-surgery pain.

I can not get a different mind set or learn to cope without these painkillers, I wish I had this option. I tried to reduce the painkillers in the first few months, as I was concerned some of my symptoms might be related to it my doctor said I could try coming off, but she was sure it wasn’t the case. The doctor was right and in trying to get the pain under control again meant a higher level of painkillers. It was so, upsetting all around.

I will be getting addicted to the pills the doctors are giving me, as I will be on them for the foreseeable future.

My body does adapt to the medication, which is why my Amitriptyline dose has increased from 10 to 30 mcg a day and my Gabapentin was moved from 900mcg to 2700 mcg a day. This will continue to happen.

There is no way of avoiding taking painkillers, becoming addicted to these painkillers, nor preventing the increase in dosage. I do know this; I just don’t like this answer. It makes me sad; I wish I had another option but I can’t function with untreated nerve pain.

@MorningStarling

Crossed with your post. Yes, I do have a medical need.

I have an update on my sister, thought I'd post update as so many on this thread were so kind about the situation.

It's a positive out a negative really as my sister had yet another 'fall' out her wheelchair and this time did some damage to her hip. She was admitted to hospital just over a week ago now and luckily had not fractured her hip, but has a hematoma that has needed surgery.

The positive aspect is that the consultant immediately reviewed her medications and has reduced her sedative load considerably and she is on a plan to taper down further. As she is an inpatient, she is receiving help to manage this, with doses of extra pain relief prescribed when she finds it too much.

The change in her has been remarkable. She is now alert, can hold a conversation and has even watched a movie all the way though without dropping off or forgetting the plot!

The best part is that she can now think clearly and has described it as the fog lifting. She doesn't want to go back to the way things were which is real progress.

The hospital have also sorted out OT and physio help to ensure she is in the right wheelchair and can manage it successfully. All things which were additional factors in the falling episodes.

We have a long road to go, but I'm so glad she has finally had the meds review we knew she needed. It's just shame she had to hurt herself and be admitted before this could happen.

@DopesickSis
Just reading your update.

Glad your sister has got so much help from the hospital, following her fall. I hope she follows the new medical doses and continue to see her fog rise