There is quite a bit of confusion and mislabeling of people on long-term use of pain medication.  Many patients are identified as “addicts” when they really are not.  To help clarify this issue a consensus document was developed by the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine.  They have agreed upon the following definitions for, tolerance, physical dependence, pseudo addiction and addiction:

Tolerance

Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution (lessening) of one or more of the drug’s effects over time.  To put it simply, tolerance means that it takes more medication to get the same level of pain relief.

Physical Dependence

Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist (antagonist meaning blocking the usual effect of the medication).  The simple explanation is that if you stop taking some medications too quickly you will have significant withdrawal symptoms.

Pseudoaddiction

The term pseudoaddiction has developed over the past several years in an attempt to explain and understand how some chronic pain patients exhibit many red flags that look like addiction.  Pseudoaddiction is a term which has been used to describe patient behaviors that may occur when pain is under treated.  Patients with unrelieved pain may become focused on obtaining medications, may clock watch, and may otherwise seem inappropriately drug seeking.  Even such behaviors as illicit drug use and deception can occur in the patient’s efforts to obtain relief.  Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when the pain is effectively treated.

Addiction

Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations.  It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Over-Medicating and Under-Medicating

Learn How To Make Healthier Pain Medication Decisions

Many people in chronic pain are afraid to take their opiate pain medication because they have heard horror stories of people getting hooked on pain pills.  This leads to a decision to under-medicate and then they end up suffering as a result.  On the other hand not taking effective precautions could lead to developing an addictive disorder.  If you happen to be in recovery for alcoholism or another drug addiction the problem is even worse.  If you under-medicate it could trigger a relapse.  Of course the other side of the coin is overmedication; which could lead to rapid tolerance building and finally reactivation of an existing addictive disorder that was in remission.

To learn more go to our Publications page and check out my Addiction-Free Pain Management® Module Two: Examining Your Potential Medication Management Problems.  To purchase this module please Click Here.

To listen to a recent radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the November issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.