Well put Jane. It can be a slippery slope but the difference in quality of life without them is tremendous for me. Gramps I think with your wisdom a this level of life you could find the balance.

Well said Jen....Perhaps I should have used the word Depended instead of addiction.....I know there is a huge difference. Maybe, I'm just worrying to much about nothing. My son became 'addicted' to pills, perhaps that's why I said that. But, like you said, there's pain management and there's recreational, he was using them for a completely different reason.

Another thing to think about: addiction in general does seem to have some hereditary components.

If your family is filled with alcoholics, heavy smokers, and a drug-user or two, it's one thing. If there's little or none of that and if you are the guy who just quit smoking one day without ever thinking about it again, it's something else.

I had that same fear when I first started taking vicodin but I have taken vicodin for 10 years now... and only as needed and I don't have a problem with addiction... But again I don't take them every day I just use them when the pain is too much for me to handle. I might take them 3 to 5 days in a roll but then it might be a week or so before needing them again... I don't think I have ever used up a 30 supply in 30 days... So I am sorry I am not much help to you because for you it sounds as if you need something to help with the pain every day at least for a while... may be you should consider going to pain management dr for the pain and let them know you don't want to get addicted to pain meds but that you really need help with the pain. You sure don't need an addiction to have to work with too... You really need to get that pain under control so that you can keep moving or it will just get worse. Another suggestion is maybe take them as needed for 10 days you just might break the pain cycle... my reason for saying this is after most surgeries your dr will give you prescriptions for vicodin for 10 days so addiction is not likely in this case. My prayers and thoughts are with you.

I was typing while you were posting. Having had a son battle addiction certainly gives you a different view.

Grandpa,

You voice a valid concern. As previously mentioned, there is a huge difference between dependency and addiction.

If you are dependent, you will follow the instructions for taking the medication, you will not get a 'high' from taking them, and you don't have a craving for more.

With addiction, getting the 'high' is first and foremost. The person craves more and more medication in this situation to satiate these type of cravings.

A rheumatologist or pain specialist will be very helpful is getting you off of these type medications when the time is right. If you have been taking these type medications for a while, they don't simply stop them on any particular day. You will be appropriately weaned off of the meds.

You should not live your life in pain and go without eating or sleeping when a solution has been presented to you. Especially when you state that they offer comfort.

If you find yourself over medicating yourself or taking more than prescribed to get a 'high', that would be a problem that you would want immediate help for.

Your fears are valid but easy to deal with when the time comes.

Be well Gramps,
TheWino

Really nice replies so far and good sound advice. I know I don't have the desire to get the high a few of you spoke of, so I guess my fears aren't as bad as I thought. My son struggled in his 20's and pretty much messed up his life with pills...he's now 42 and on disability and lives with his mother. I'm sure that lingers in the back of my mind because I often wonder where his addiction came from. I was never into pills or graving that feeling that's been mentioned.

I think I'll put my fears to rest and instead of sitting here in tears from the pain, follow my doctors orders and use them as directed. See, that's why, I love this board. You get solid advice from people that have gone/going through the same thing you are. You guys/gals are great!!

All great comments so far.

Grandpa - you seem to be at the stage I was about 1 year ago as far as the RA meds not working and dealing with the pain.

I learned a lot from my wife who has really bad chronic sciatic nerve pain.

My PCP prescribed me with Norco which is very similar to Vicodin - 7.5mg also.

I had the exact frame of mind that you say back then, and only took a pain pill if it got so bad I couldn't stand it. I can also relate to having no appetite when the pain was so bad. One thing I learned from all this, is waiting to take it until the pain is real bad, all you are doing is chasing the pain instead of trying to prevent it. I finally got so fed up with the pain that I tried what my wife suggested and started taking 3 pills regularly during the day. Doing this offset the pain before it got bad, then occasionally take an extra one as a break through if I was having a really bad day.

One in the morning - one in the afternoon, and one in the evening. This has made a huge difference for me. I can actually do some light chores here and there now.

I spoke with my PCP about doing this and she agreed that it is fine doing it this way. She writes my Rx for 135 per month which gives me some leeway for those days that I need an extra one or two.

Just a suggestion as I know we are all different. I'm not worried at all about becoming dependent on them. I find that keeping that small amount going constantly helps so much in keeping the pain at bay instead of chasing the pain afterwards. My wife (and my dr agrees) that you would need much more medication to try to stop the pain after it starts than needing a smaller amount to keep it somewhat at bay.

This was a huge step for me to start doing this - almost as if I were giving in. But after 6 months of chasing like you say you are doing now, I got fed up with being in constant pain and not even being able to move off my chair.

My journey with chronic pain began a few years before my diagnosis of RA. As I put in another post I did not like meds of any kind. I was struck with pain that caused me to vomit & landed me in ER, including transported from a doctors office. Vitals going bonkers & unable to breathe at times. I had to make a choice start pain meds or continue this viscous circle.

Cut a long story short ended up in pain management. My husband & I were both concerned about addiction. I struck gold with a wonderful doctor who sat us both down & explained the difference between addiction & dependence.
If pain meds are taken on a daily basis the body becomes dependent.
It can build up a tolerance so the dose is not as effective. Although I've met many people who remained on the same dose for years.

There is a big difference between dependence & addiction.
This doctor warned me to take the med as prescribed. Never early, never take more the prescribed & never for any other reason.
I had a friend in a support group explain it best, then again he was a rocket scientist. (No kidding)

When the body is in pain the meds target the pain. You don't get that "high" or "euphoria" feeling some may get like with abuse or addiction.
So the brain uses these meds to block the sensation of pain. Sorry not good at explaining things anymore.

With pain meds less is better & stay a head of the pain.
Never in a million years would I have. Imagined I'd enter the world of pain management or meds but I did & I did not want to enter blindly.
As much as it bothers me I thank god for my PM doctor.

Now I have a huge family & yes a couple that had addiction problems. Yet never seem to be a problem with me. I took my doctors words as gospel & even with pain that had me feeling like I could not make it never took over the amount prescribed. I'd call & get in for an appointment but I have a healthy respect for the world of pain management. I do get injections, nerve blocks & other procedures done. So for me PM is best.

I can't see suffering to the point ones life is disrupted in every way. Just my opinion but if medication can help take ones life back then so be it.
A good doctor will understand your concerns & address any you have.
The best of luck to you.
Sammy

I completely agree with the difference between dependence and addiction - no arguement there and really well put on all the other posts, but like Gramps - I would worry that my dependence might become an addiction before I was even aware.

Gramps - you NEED to have some quality of life and you DESERVE to have a break from the pain - so please take the meds!

Maybe as a comfort and a precaution, get a loved one very involved in monitoring when and how much you take - maybe put the onus on them to 'administer' the medication when needed to remove some of that fear.

All the best to you - I hope you feel better very soon. Hugs.

That's why they are so strict about taking as prescribed.
My doctor wanted my husband present for any & all changes
Has nothing to do with trust but everything to do with another set of eyes & ears & knowing what to watch for when changing or dosing
They know what to watch for & the patient has to be educated & responsible. My doctor made it clear he would not abandon any patient who came to him with problems. I wish everyone could have a doctor like him
Sammy

Grandpa this is a very good topic you started since pain is very much a part of RA and many of our lives. If you have not had an addictive personality before, I would not worry to much about that now and you must think of quality of life. i do understand and am so sorry to know of your son. That can be very disheartening and make one wonder if the same thing could occur in my life as well. I believe with RA one must weigh their options quality of life..pain meds.. biologics..possible side effects of medications.. being able to live your life the best way you can.All of this must be taken into account with this disease.

I am not one for being in pain. I do not do well and I cannot function. I have to function as I have several more years to work and at times have to care for my mom with Alzheimer's. I have a pain management doctor. I am on a Butrans patch along with Nucenta tabs. The Butrans patch works well and comes in varying degrees of dosages. I don't think about addiction or dependence as I only take pain pills when I need it. It depends on my pain level. If I can take a Tylenol and that will do the trick or help that's what it will be. I also have to take my pain medication according to work schedule. I know I cannot take Nucenta and go to work. Though most times it does not make me sleepy but I will take a Motrin if I am at work and pain starts and grit through the pain and when I get home take something stronger. When I am off and home I am not going to sit and bear pain no way. I can take my pain medication as directed and rest. That is what helps to relieve the pain with me. I think a pain management consult would help you Grandpa2. Good luck in managing your pain. Please keep us posted.

Grandpa, I believe you are suffering needlessly. Please take your pain med as directed by your physician. Pain from RA can be a viscious cycle & if not treated it can escalate to the point that even the pain med won't work as intended. If you are having severe pain on a regular daily basis then you need to take your pain med on a regular basis. If you have an improvement in symptoms & less pain then take the pain med as needed. You'll see your quality of life improve significantly, best wishes!

hi, i'm steph gas and i'm an alcoholic and addict. i'm also in the process of being certified by my state to be a drug and alcohol counselor.

the difference between dependence and addiction has been very well explained; however, dependence is not necessarily a good thing or 'okay'. if your body becomes dependent on one type or dosage of pain meds, more or different meds will be required. many of these medications have side effects that can interfere with your daily life - you may be unable to drive or focus on specific tasks safely.

the line between dependence and addiction is slight from a medical viewpoint; addiction requires one more criteria be met. i've done specific things in the past to help alleviate my fear of becoming dependent or addicted to pain meds. first is that i never allow my doctor to write me an 'as needed' script. some doctors will just be like, here's 30 oxycontin pills, take them as needed. i need the doctor to tell me how often i can take them. if it's every 6-8 hours, i ensure that at least 8 hours has gone by before i take another. i always make someone else aware of what pills i'm taking and leave them in a public area - i tell my husband any time i take a pain med and try to get him to see how many are left. he trusts me more than i trust me and often tells me i'm overreacting.

you deserve a good quality life. there are medications that will help you, it's about finding one that works for you. i remember when i used to have darvocet, i loved it because it was eased my pain just enough to make it okay (it was like an ache that i only noticed once in a while) but didn't make me feel high or loopy. that's what i think anyone with pain management needs should be looking for. my girlfriend can eat vicodin like candy and it does nothing; it knocks me on my ass and i will start slurring my words.

if tramadol hasn't touched the pain, let the dr know (and please responsibly dispose of the pills - ask your pharmacy how to do so, or your local police department may take them). if the vicodin has helped, use it. if the higher dosage makes you feel high at all, i'd recommend asking for a lower dose. you don't want to eat them like candy - but you don't want to sit around in pain all the time.

as long as you continue questioning yourself and not beginning the cycle of denial then you are probably well on the way to proper management of your individual situation.