Re: Re: Evening Stiffness, Pain and Pills

[Guest guest]

Addictions develop as your body acclimates to the medication. They're both physical and psychological. The psychological addiction is when you can't stand how you feel without the meds -- generally because it smooths out your mood, you don't get irritable, things don't bother you. Over time, you become less and less able to handle routine irritations because when you're on the meds, they don't bother you. It's like getting rusty because of lack of "practice" with them.

The physical addiction is when your body gets used to the meds and it gradually needs more and more to maintain the same level of functioning. If 25mg of something makes you pain free, and that increases over time(you need more of it the longer you take it), you're building up a dependence on it. But a dependence isn't necessarily a true "addiction" as we understand it. It can certainly lead to it.

Some drugs have an extremely high addiction potential, like morphine. A good shot of morphine has a definite physical effect, and the more often you use it, the more it takes to get that effect. When the effect wears off, your body "screams" for it again -- the pain may be worse than it was before you even did the morphine, your nerves are all on edge, you feel like you're flying apart and can't maintain until that next dose. That's addiction. Unfortunately, some people need very addictive drugs for severe pain, and the danger is always that they'll take too much for too long, and then hit a ceiling where they can't take anymore(or they'll overdose), but the pain isn't controlled any longer because the body is demanding a higher dose. That's why traditionally doctors have been reluctant to prescribe opiates for long-term pain management. Now they're learning how to do "cocktails," and use other drugs in conjunction with them, as well as biofeedback and other methods, to manage pain over long periods.

----- Original Message -----

From:

Rheumatoid Arthritis

Sent: Sunday, August 28, 2005 9:10 PM

Subject: Re: Evening Stiffness, Pain and Pills

Hi Sam,I am not sure how addictions to pain pills work, but addictions do not happen to everyone. I have had pain meds Rxs for 2 years now and I can go for months without needing a pill and sometimes have a bad day or days and need to take them. I have chronic pain, something is always hurting and I am careful to really evaluate if I need to take a pill. Usually when I start screaming or tears spontaneously roll down my face is when I reach for one or someone has to reach for one for me.Some do not wait that long and chastise me for that. But sometimes I am not sure where my pain is going, could get worse, stay the same or die down, you know? Sometimes when I have had like a medium to high level of pain all day I will take one, when I just want a break!Also in regards to Humira, some people do feel better quickly but it can take a few months.> > > Hi Sam- I find that pain management works well. If you find your > > pain and stiffness are more pronounced in the evening, perhaps > > taking pain meds, such as ibuprofen at dinnertime might help. I > > take my meds BID which is twice a day. That means am and pm. PM > > can be with dinner or before sleep. I found that taking a > > milligram of prednisone and ibuprofen in the pm, makes all the > > difference. If I have overdone it, which is often the case, I > > take an ibuprofen and it helps. I also drink something hot, like > > tea with the pills, so they will start working alot faster. I find > > that hot showers arent just for the am but for the pm too. > > Nothing like an ibuprofen, hot tea and dessert. I only take it > > if my bones hurt badly in the evening. With effective pain > > management, by listening to my body when it hurts, I get by well. > > Yours, Deborah> >> >

[Guest guest]

After getting everyone's wonderful feedback I am off to see my primary care doc this morning to discuss options. I went off to a book club last night (a tad bummed-- had to leave early due to pain in left foot and hands) at and Noble. Looked up Vicoprofen in a medication reference book and found that it should not be used long term for RA. So regardless of physical/psych. addiction I need to find a new med. I also found an awesome book, "Living with Rheumatoid Arthritis" put out by s Hopkins. Really a great reference book, I am going to mark some parts for my sweet husband to read so we are more in sync on this thing. Highly recommend it just to keep around, loads of info on meds, attitude, diet, alternative options, defining the disease etc...Thanks again for everyone's input!!! Have a great day,SamOn Aug 29, 2005, at 5:41 AM, Hasenstab wrote:Addictions develop as your body acclimates to the medication. They're both physical and psychological. The psychological addiction is when you can't stand how you feel without the meds -- generally because it smooths out your mood, you don't get irritable, things don't bother you. Over time, you become less and less able to handle routine irritations because when you're on the meds, they don't bother you. It's like getting rusty because of lack of "practice" with them. The physical addiction is when your body gets used to the meds and it gradually needs more and more to maintain the same level of functioning. If 25mg of something makes you pain free, and that increases over time(you need more of it the longer you take it), you're building up a dependence on it. But a dependence isn't necessarily a true "addiction" as we understand it. It can certainly lead to it. Some drugs have an extremely high addiction potential, like morphine. A good shot of morphine has a definite physical effect, and the more often you use it, the more it takes to get that effect. When the effect wears off, your body "screams" for it again -- the pain may be worse than it was before you even did the morphine, your nerves are all on edge, you feel like you're flying apart and can't maintain until that next dose. That's addiction. Unfortunately, some people need very addictive drugs for severe pain, and the danger is always that they'll take too much for too long, and then hit a ceiling where they can't take anymore(or they'll overdose), but the pain isn't controlled any longer because the body is demanding a higher dose. That's why traditionally doctors have been reluctant to prescribe opiates for long-term pain management. Now they're learning how to do "cocktails," and use other drugs in conjunction with them, as well as biofeedback and other methods, to manage pain over long periods.  ----- Original Message -----From: Rheumatoid Arthritis Sent: Sunday, August 28, 2005 9:10 PMSubject: Re: Evening Stiffness, Pain and PillsHi Sam,I am not sure how addictions to pain pills work, but addictions do not happen to everyone.  I have had pain meds Rxs for 2 years now and I can go for months without needing a pill and sometimes have a bad day or days and need to take them.  I have chronic pain, something is always hurting and I am careful to really evaluate if I need to take a pill.  Usually when I start screaming or tears spontaneously roll down my face is when I reach for one or someone has to reach for one for me.Some do not wait that long and chastise me for that.  But sometimes I am not sure where my pain is going, could get worse, stay the same or die down, you know?  Sometimes when I have had like a medium to high level of pain all day I will take one, when I just want a break!Also in regards to Humira, some people do feel better quickly but it can take a few months.> > > Hi Sam-  I find that pain management works well.  If you find your  > > pain and stiffness are more pronounced in the evening, perhaps  > > taking pain meds, such as ibuprofen at dinnertime might help.  I  > > take my meds BID which is twice a day.  That means am and pm.  PM  > > can be with dinner or before sleep.  I found that taking a  > > milligram of prednisone and ibuprofen in the pm, makes all the  > > difference.  If I have overdone it, which is often the case,  I  > > take an ibuprofen and it helps.  I also drink something hot, like  > > tea with the pills, so they will start working alot faster.  I find  > > that hot showers arent just for the am but for the pm too.    > > Nothing like    an ibuprofen, hot tea and dessert.  I only take it  > > if my bones hurt badly in the evening.  With effective pain  > > management, by listening to my body when it hurts, I get by well.   > > Yours, Deborah> >> >