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Re: Meds: Addiction vs. Medical Dependence

Posted by linkadge on August 23, 2010, at 12:32:51

In reply to Re: Meds: Addiction vs. Medical Dependence, posted by Phillipa on August 23, 2010, at 10:49:02

Good question. Christ_Empowered made some good points.

I think it really just boils down to whether your doctor wants to portray your predicament as a "good thing" or a "bad thing". This, of course, depends on what is considered good medical practice at the time.

The problem is that, with many agents, it is possible to be both medically dependant and addicted.

Take paxil for instance. There are people who are medically dependant on paxil i.e. they need to keep taking it or else true return of the depression disease will occur. There are also people who are addicted to paxil. These people don't need the drug for depression any longer. However, they cannot stop because withdrawl symptoms are too severe.

In the latter case however, doctors still tend to refrain from referring to this being addiction. After all, to do so would be to classify paxil as an addictive substance, which would be a bad thing for the buisness.

Because of the whole antidepressant addiciton/dependance argumnet, the current tendancy is to classify addiction as using a substance which:

-loses effectiveness at a consistant dose, and requries dosage escalation for effect.

-gets people "high". The patient "likes" the high effect, which is biologically seperable from the medicinal effect.

There are other drugs which can fall into either category or both categories.

- benzodiazapines
- stimulants
- opiates
- certain anticonvulsants (like gabapentin)
- antidepressants *

I personally believe that antidepressants meet all the criteria for addictive substances in some patients.

For instance, some patients "like" the effect of antidepressants, i.e. the drugs give them a bit of a high. Some patients need dosage escalation to maintain the theraputic effect. Some patients have severe withdrawl if drug use is interupted.

With the advent of the SSRIs, there is a tendancy to consider benzodiazapines addictive or habbit forming. In studies of new anxiolytic agents, I have seen researchers refer to the new substance as not producing withdrawl symptoms like the SSRI agents. So, over time, doctors may change their classification of a substance based on which agents are used to treat a condition.

I think the bottom line is whether you are taking the substance for a legitimate medical condition and whether you are taking the medication as instructed. If so, doctors tend not to use the word addiction.

Linkadge



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