First off, thanks, muchly, for the kind and supportive words following yesterday’s post. I didn’t expect to get flamed here, all public and on my own blog and stuff, but there’s always that hesitation to open yourself to the kinds of discussions that you know are not black-and-white, but that you also know that there are any number of people out there who are more than willing to turn it into a black-and-white topic, with pointed fingers and blame and rigid standards.
And, second, for what it’s worth, and I realize it’s a small distinction and matters to only a tiny, tiny population of people, but since I’m one of them, I’ll say it:
I’m not addicted.
I am physically dependent, to the point that I have experienced strong and unpleasant symptoms from withdrawal even when I’m carefully and incrementally stepping down from the medication. I don’t know if that’s because opiates – or, at least this particular one – are just that strong, or if I’m just that susceptible, or a combination thereof.
But I’m not addicted.
Addiction is something I had to keep a close eye out for, in all of my previous jobs, and is a topic I’m quite familiar with. It shares a foundation with dependence: both involve a physical response to a given chemical, and a (different, less pleasant) physical response to the removal or said chemical. Both are hard to work through. But the difference is, addiction carries with it an extra set of psychological symptoms and complications, which of course vary from person to person… but it’s things like, a craving for that chemical, a wish to be able to continue it despite admittedly negative effects on the user’s life, an ambivalence – if not outright resistance – around the idea of stopping, a basic sense of self and identity that becomes entwined with the substance, itself. Much in the way that you can differentiate between a sometime-jogger and a marathon runner, one being a hobbyist and the other being an athlete, so can you differentiate between someone using a given medication because they feel it is necessary to obtain a certain lifestyle but would be just as happy using or doing something else if that something else was effective, and an addict.
Physical dependence is a medical condition. Addiction is a lifestyle.
I was worried, a little, here and there, before I started this whole weaning-off process. I knew that I was taking pills that were legally and appropriately prescribed for me, that I was not deliberately inflating my symptoms to as to receive more pills, that I was following the prescribed dosing schedules and was not spending my time counting pills or running out before I should have. But I imagine there are any number of people with full-on addictions who have learned how to manage their medications in a similar manner. I wondered if, once I started to step back from it, if some part of me would rebel… if I would suddenly find a reason to make an earlier-than-planned doctor’s appointment that would allow me to continue taking “just a little,” or if I would feel a pull to just scrap the whole process and get back on the full dose of opiate and proclaim myself unable to live without it and we’ll let the baby deal with whatever happens, or if I would cheat, or actually fail. I wondered, and I worried.
And now, almost a week in, I can say with some assurance and a great deal of relief, that I was wrong. I’m not second-guessing any of this, and I have no desire to reverse the process in any way. I’m down to something like five doses of the opiate, and then I will be altogether out. Instead of triggering feelings of panic or anxiety in me, this knowledge helps settle me; in just a few more days, I will be out, and that will be that. I’ll have a few follow-up days of more intense discomfort, I suspect, because I won’t have even the small, half-doses I’m currently using to push through when things get particularly bad, but then it will be done. I’ll be left with back pain, sure, because that’s the nature of the beast, but the withdrawal will be over and I can pat myself on the back – assuming my stomach isn’t so tremendous as to prevent such acrobatics – and move on to the next thing.
So, as I said, it’s just semantics, as far as most people are concerned. Dependence, addiction, same damn thing, right? But, no. Wrong. At least, for me. And that helps, some days quite a lot.