Re: Dr's Visit

From: Marla (onery1@soltec.net)
Sun Jun 18 10:38:09 2000


From: Poutinen, Jay

>Please explain? What is the difference between addiction and dependency?
>Thanks.

>From http://www.merck.com
http://www.merck.com/pubs/mmanual/section15/chapter195/195c.htm

Opioid Dependence A strong psychologic dependence manifested as an overpowering compulsion to continue taking opioids, the development of tolerance so that the dosage must be increased to obtain the initial effect, and physical dependence that increases in intensity with increased dosage and duration of use.

Physical dependence necessitates continued use of the same opioid or a related one to prevent withdrawal. Withdrawal of the drug or administration of an antagonist precipitates a characteristic, self-limited withdrawal syndrome.

http://www.merck.com/pubs/mmanual_home/sec7/92.htm Drug Dependence and Addiction Addiction is the compulsive activity and overwhelming involvement with a specific activity. The activity may be gambling or may involve the use of almost any substance, such as a drug. Drugs can cause either psychologic dependence or both psychologic and physical dependence.

Psychologic dependence is based on a desire to continue taking a drug to induce pleasure or to relieve tension and avoid discomfort. Drugs that produce psychologic dependence usually act on the brain and have one or more of the following effects:

Reduce anxiety and tension Cause elation, euphoria, or other pleasurable mood changes Produce feelings of increased mental and physical ability Alter sense perceptions

Psychologic dependence can be very powerful and difficult to overcome. It is particularly common with mood- and sensation-altering drugs that affect the central nervous system.

For addicts, drug-related activity becomes such a large part of daily life that an addiction generally interferes with the ability to work, study, or interact normally with family and friends. With severe dependence, the addict's thoughts and activities may be predominantly directed toward obtaining and taking the drug. An addict may manipulate, lie, and steal to pursue the addiction. Addicts have difficulty giving up drug use and often return to it following periods of abstinence.

******************************************************************** To summarize - I am physically dependent on Fentanyl to relieve my pain. But that's all it does for me is relieve the pain. It does not create any

--
euphoria or altered state. However, someone who used who did NOT have pain
probably would feel euphoria and could become addicted to that feeling and
seek the drug even though they had no pain. I will have to "wean" myself
from the drug - reducing the dosage over a period of time - but once the
pain is gone there should not be an overwhelming desire to get the drug
again and again because no euphoria (or any of the other three
manifestations of addiction) was experienced. So it's not an addiction, it's
a dependency.

Did that explain it better Jay? Marla


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