What is the difference between physical dependence on a medication and addiction?
Answer
Physical Dependence is a natural physiological process. We have receptors to pain in our body and when the pain medicine is controlling those receptors the body stops trying to do it by itself. It relies on the pain medicine. People become physically dependent. If you stop the pain medication all of a sudden, the body wonders what just happened because it is not ready to take the job back over. As a result, the patient feels extreme pain, body aches, irritability, and/or tachycardia. Pain medication should be titrated or slowly weaned when someone has been taking one for a while so that the body can take over the job and start to control the pain. That is not addiction. Addiction is when you use the medicine for something other than controlling the pain. You are using it for a high or a low or some other good feeling. Your patients are not addicted. If they stop their medicine all of a sudden and they feel miserable, they are not addicted. They are tolerant to that medicine and physically dependent on it . They are experiencing withdrawal. Sometimes when this happens, the patient gets very agitated and anxious for their medicine.
Michelle A. Fritsch, Pharm.D., CGP, BCACP
Michelle Fritsch, Pharm.D., CGP, BCACP is a clinical pharmacist with a passion for geriatric health and education. She is currently founder of Meds MASH, LLC, a company dedicated to reducing risks posed by medications and falls in mature adults. She was from 2008-2014 founding Professor and Chair, Department of Clinical and Administrative Sciences at the Notre Dame of Maryland University School of Pharmacy in Baltimore, Maryland. Dr. Fritsch received her Bachelor of Science in Pharmacy and Doctor of Pharmacy degrees from Purdue University. She then completed a primary care residency at the William S. Middleton Veterans Affairs Medical Center in Madison, Wisconsin. Prior to her arrival at the Notre Dame of Maryland University, Dr. Fritsch founded and directed the Alamance Medication Assistance Program (AlaMAP) of Alamance Regional Medical Center (ARMC) in Burlington, North Carolina from 1997 to 2008. The AlaMAP clinic provides medication therapy management and medication access to a geriatric population in Alamance County, North Carolina.
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