You are like a lot of good people. You work hard on your career or job. You nurture important relationships, like your marriage and your relationship with your children. You love your pets. You’re involved with friends, with your community. You exercise and enjoy your life.
And then you get hurt, or have surgery, or both. Suddenly, your life changes a bit: you can’t do everything you did before. You have to deal with recovery from the injury or surgery. You get a prescription for pain meds from your doctor, and frankly, that’s a good thing. Because you have pain.
You take your meds as prescribed, and the meds help the pain. You focus on healing, on getting your life back to how it was before. But healing takes time, and so you’re on the meds for a while, maybe two or three months.
Tolerance and dependence are normal “side effects” of pain medications. They happen even when you’re doing everything right, following your doctor’s directions. Dependence is not addiction. But as dependence kicks in, how you manage your use of the pain meds can make all the difference between the two.
In short, your body adjusts to the pain meds you take over time, reducing the med’s ability to knock out your pain. That’s tolerance, and when your body builds it, increasing the dose of your meds, or taking them more often, can seem like the right thing to do. A higher dose brings back the pain relief.
Physical dependence grows as tolerance builds, but dependence is only noticeable if you don’t increase the dose. You’d want to increase the dose because “the meds aren’t working well anymore”. If the meds aren’t working well anymore, you’re likely to feel discomfort, or have trouble sleeping, or perhaps you’re anxious about getting enough meds to quell the pain. What you’re feeling is withdrawl, and you’re not a bad person if you feel it. It’s quite normal. Even if you’re doing everything right. The question is what to do about it.
First of all, at this stage you’re not “addicted” to your pain meds, but you are “dependent”. Though the terminology varies, true addiction is what can happen if you don’t manage the pain meds well. Dependence is normal and expected as tolerance builds - that is, all pain medications will “stop working” if you take them long enough.
True addiction bares its fangs when you ignore the warning signs of dependence. True addiction involves lying to yourself and others about your pain med use. You may tell yourself that you need the meds for reasons other than why they were first prescribed. You may be buying more meds than are prescribed, from places other than your pharmacy. You’re doing this because you’re afraid your doctor will take you off the meds altogether if you tell her that you need more than the prescribed dose. You may be missing appointments, making big mistakes at work, or not respecting other obligations you’ve made, and telling yourself it’s alright because you have pain, because you need to get more meds to take care of the pain. If any of these things start to happen, then you are moving from dependence to addiction.
What to do? First, don’t feel embarrassed. This is what the meds do. Second, reach out for help. Reach out to your doctor and explain what’s happening. Your pain is probably still very real, and you need chronic pain management, which involves a disciplined use of pain meds and counseling that helps you stay on track to manage your physical dependence. A disciplined and caring approach will keep you from straying into addictive behaviors. When the time is right, you’ll reduce and eventually eliminate your use of the meds as your injury heals and your pain fades.
You can also reach out to Lionrock. We understand what you’re experiencing, and we can help you. We’ll communicate with your doctor, help you create a plan for using the meds to manage your pain effectively, and we’ll support you through the whole process, until you’re safely off the meds and no longer in pain.
Feel free to reach out to a Lionrock counselor today, using the contact form on this page.