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Aster's avatar

With unbearable pain, isn't addiction to Vicodin preferable to losing quality of life?

Asked by Aster (18320points) May 4th, 2014

My ex has spinal stenosis that came on gradually . A neurosurgeon told him surgery wouldn’t do any good. He is on Vicodin now and goes to pain management centers. He told me he really needs a lot more meds to deal with the 24/7 pain and uses a cane. I think, but am not sure, that this is often how addiction to opiates begins. He said he is concerned he may run out of pills. Is it not better to give patients all the pills they need rather than to withhold them due to fear of addiction if their quality of life depends upon being in less pain?

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17 Answers

RealEyesRealizeRealLies's avatar

Boy I don’t know. My time with Vicodin was rewarded with severe depression, to the point of constant crying. I’m glad to be away from that.

But I’ve had pain severe enough to cause the same thing, to the point of questioning whether I wanted to go on.

I just don’t know. I hope things get better for you.

GloPro's avatar

Here is a list of signs and symptoms of Vicodin overdose. This list does not sound like an improved quality of life to me. It is possible to develop tolerance and eventually OD and die if self medicating becomes an issue. If there is alcohol involved the chances increase greatly.

Spinal stenosis is debilitating, and I am sorry he is having to struggle to find relief from chronic pain. Why did the neuro tell him surgery would not help?

Maybe yoga, which would stretch the spine, would be something to try. It isn’t a fix, but may help slow increasing his dosages of pain meds. At the very least I would combine several methods of finding relief and not just drugs.

janbb's avatar

I think that chronic pain is terribly debilitating and that it is worth taking the risk of over-dependence if that is what it takes to live a meaningful life.

Dan_Lyons's avatar

Because of the archaic laws governing pain meds here in the US, doctors err in doling out lesser pain meds for chronic users.
If your ex is in dire need of these pain meds and in fear of running out, he should have a heart-to-heart chat with the prescribing dr.

Yes, addiction to Vicodin [morphine, oxycontins, opiates of any sort] can cause serious behavioral abnormalities; but as my gold-digging step-mother said about dad, “He quit all his pain meds and has become an unbearable grouch.”
He was taking pain meds for his bad back.

Lightlyseared's avatar

To be honest very few people who take opioids for chronic pain become addicted. Yes their tolerance to opioids increases and they do become dependant, but dependence and addiction are different and should not be used interchangeably.

Aster's avatar

@RealEyesRealizeRealLies Thanks, but I have no pain. It’s my ex I was speaking about.

Dan_Lyons's avatar

“very few people who take opioids for chronic pain become addicted.”

This sentence is erroneous, @Lightlyseared

Aster's avatar

A friend of mine has occasional hand tremors from painkillers. The tragic part is she has no pain. She takes them to escape the depression from her husband’s alcoholism. Or to escape her life. Upon outward appearances she has everything going for her.
He was hospitalized for it (DT’s?) then began drinking within two weeks.
She is such a sweet person. Very nice.

CWOTUS's avatar

Despite @Dan_Lyons’ bland assertion, my own reading – not firsthand experience – tells me that when opioids and other narcotics are taken for legitimate long-term pain management, there is much less chance of addiction. There is always a chance of addiction; especially since not all patients and not all doctors are honest. Pain described by a real sufferer may not be as intense as what the good doctor comprehends, so the doctor may over-prescribe unintentionally. That could lead to a dependence on the drugs, which could easily morph into a full addiction.

Good doctors are always cognizant of that, and for that reason will usually only increase the dose gradually, relying on a patient’s honest feedback about what is or is not working to manage the pain. But not all patients are honest, are they? Some only mimic pain symptoms because they are already addicted and simply want a legitimate source of more meds. On top of the doctor’s own concern for his patient, the DEA is clamping down hard on the “Doctor Feelgood” operators, who are basically drug pushers who happen to have a license to practice medicine.

Because of heavy DEA oversight over the entire dispensing process, a huge majority of “good” doctors tend to avoid any kind of “pain management” specialty, because they can’t deal with the constant investigation and harassment that comes with it. Of the good doctors who do specialize in pain management, they tend to accumulate more and more patients from farther and farther away, which means that they are dispensing and prescribing more and more drugs to more and more people. Consequently, they call down more and more “investigation” on their heads. It’s a tough situation to be in for the doctor and for the patient, because as doctors are driven out of the field, whether because of retirement, overwork, or mistakes that lead to prosecution and loss of license, the patient who already couldn’t find a doctor close to home now has to go farther afield to prove his pain is real to another doctor, and go through the same “be careful and start slow” process with a new physician.

On top of that, of course, is the decreasing efficacy of opioids over time. Assuming that “a source and level of pain” remains constant, it takes more and more of a given drug to handle that level of pain. The body develops a tolerance to a drug, and the physician, knowing this, has to gradually increase the level that’s administered, just to maintain a status quo. If the pain is worsening over time due to level of illness or structural malfunction increasing, then that compounds the problem.

So now there’s a situation where a more-or-less overworked doctor, who has probably more patients than he can comfortably see, from farther and farther away geographically, and whose practice is more or less dedicated to dispensing very strong painkilling drugs… in increasing doses. So the DEA increases their level of surveillance. It’s a very vicious cycle.

As patients die, as all kinds of doctor’s patients (and all of us, anyway) eventually do, if the cause is the least bit “drug-related”, then another doctor is pilloried, stripped of his license and discarded, or worse. And the problem doesn’t get better.

From a “community” perspective, it’s a bad thing for a good doctor to risk over-prescription, because it can harm his patient, wreck his practice and ruin the lives of a lot more people that you can’t see.

Dan_Lyons's avatar

@CWOTUS As bland as it may be, it is simple facts; gleaned from many people I know who have had these kinds of meds prescribed them.

Of course the medical community is going to tell you that you won’t get addicted if taking opiates for real physical trauma. What did you expect? The truth? That you will become addicted and destroy your life and your family over opiates.

Get real. Opiates addict and then withdrawal is much harder than most people are able to handle and so they tend to try lesser drugs when attempting to quit, thus opening the door to multiple addictions.

GloPro's avatar

@Dam_Lyons @CWOTUS It was my experience when I had a very serious injury with a long recovery time that my doctor was definitely concerned with my developing a dependence on and tolerance to narcotics. At my own request we tried several less addictive drugs until we found what worked for me.

Also by my own personal experience as a drug abuse counselor have I witnessed people struggling with this same choice. Tolerance leading to higher doses leading to addiction and withdrawal, which often exacerbates the chronic pain. It’s almost an possible place to be in. That’s why my suggestions are approaching chronic pain from many angles, not just medication.

Aster's avatar

@GloPro he has a long history of dishonesty but he told me he has tried yoga, owns a slant board and has also tried prayer. He was always either an Atheist or Agnostic when we were together but his girlfriend could have prayed . Whichever , I feel sorry for the guy. People in this predicament often find themselves “doctor shopping” to procure more painkillers. No way to live. I read the posts on WebMD on this and all of the stenosis people say painkillers barely touch their pain. My ex father in law had pancreatic cancer and he said he had to talk to dozens of doctors in Chicago before he got morphine pills. I never knew it came in pill form.

cheebdragon's avatar

People can get addicted to anything.

Aster's avatar

^^^^^^ Yes, but not all addictions are created equal. An addiction to food or drink can be fed with no problem. But an addiction to opiates is a whole other ballgame. Why? Because they’re not at the nearest grocery store and, unlike with the former, withdrawal can be quite dangerous if not extremely unpleasant.

dappled_leaves's avatar

It occurs to me that limiting the drug supply might have less to do with preventing people from becoming addicted and more to do with preventing them from succumbing to the temptation to sell their drugs.

cheebdragon's avatar

“What is dependence?
Physical dependence is a natural expected physiological response to drugs such as opioids, benzodiazepines, antidepressants and corticosteroids. It is characterized by withdrawal symptoms with the patient being unable to cope when the drug is stopped.
What is addiction?
Addiction, on the other hand, is not a predictable drug effect, but rather a disease that occurs in genetically, biologically, and psychosocially vulnerable individuals. When genetics, environment, and drug use overlap, addiction may occur.” Source

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