This post is in response to Arabella’s post regarding the difference between medication overuse headache (MOH) and addiction. We are both responding to redOrbit’s article Migraine Meds Can Become Addictive (BTW, the original AP article is better. Thanks, Parin). What followed was not on addiction, but on medication overuse headaches (MOH) or rebound headaches. These headaches occur when the culprit medication wears off and a severe headache occurs.
RedOrbit’s headline conjures images of Migraineurs sneaking out at night in dark alleys looking for their next fix. This is unfortunate because there is some truth to it. Anyone who takes a medication runs a risk in becoming addicted or dependent. This is NOT the same as abusing the drug. That is a whole other ball of wax.
In the medical community addiction or drug dependence means
is a state in which the body relies on a substance for normal functioning and develops physical dependence, as in drug addiction. When the drug or substance on which someone is dependent is suddenly removed, it will cause withdrawal, a characteristic set of signs and symptoms
It doesn’t mean that the person is liable to engage in dangerous behaviors to get another “fix”. That is drug abuse. Indeed, for most patients on pain medication, the fix is not necessarily just euphoria, but pain relief. And that certainly brings a sense of well-being.
There are many pain relievers that have the potential to cause drug dependence. Two of these are mentioned in the redOrbit article: Fiorial and Percocet. Fiorinal is a combination of three drugs: butalbital, aspirin, and caffeine. Butalbital is a sedative barbiturate that slows down the central nervous system. Patients can become dependent on butalbital and may find themselves taking Fiorinal more frequently just to function.
There is a double whammy in Fiorinal in that the butalbital can cause dependence; the aspirin and the caffeine can cause medication overuse headaches. So the woman highlighted in the article may have had both drug dependence and MOHs.
The same is true for Percocet. It is a similar drug prescribed for pain. It contains oxycodone and acetominephin. Oxycodone is an opoid narcotic pain reliever, similar to morphine. Acetominephin (Tylenol®) is a milder analgesic and enhances the pain relieving properties of oxycodone. Like butalbital, oxycodone can cause drug dependence, especially if taken more frequently than prescribed. The acetominephin can be the culprit in medication overuse headaches.
So it appears that drugs that combine a barbiturate or an opioid analgesic with aspirin, caffeine, or acetominephin carries the risk of both drug dependence (addiction) and medication overuse headaches. It does NOT necessarily lead to drug abuse.
Have an AWAP day,
Debbie
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[...] unknown wrote an interesting post today onHere’s a quick excerptThat is drug abuse. Indeed, for most patients on pain medication, the fix is not necessarily just euphoria, but pain relief. And that certainly brings a sense of well-being. There are many pain relievers that have the potential to cause … [...]
Interesting that your medical community doesn’t distinguish between addiction and dependence.
Which community is it?
Not sure what you are asking. All of the medical websites I visited didn’t distinguish between addiction and dependence. However, there was a distinction between addiction and abuse. That was the point I was trying to get across. A person could be addicted to medication (exhibit withdrawl symptoms when the medication is withdrawn), but not be an abuser. There are medications other than painkillers that are addictive. People can become addicted to blood pressure medicines, but they are not abusers.
I think you and I are seeing things the same way but may use the words addiction, dependency, abuse, and withdrawal differently. It’s an important topic and I’m glad you’re addressing it.
The quoted definition seems not to distinguish between addiction and dependency. The community that holds that belief might benefit from a different perspective.
I don’t believe I’d use withdrawal symptoms to describe such things as the physical effects of switching from one Migraine preventative to another, for example, or from one thyroid replacement therapy to another. Rest assured, a person with no thyroid absolutely must have thyroid replacement therapy in order to continue to live. Switching from one therapy to another can (and did for me) have pronounced physical effects. I still have my thyroid but it doesn’t always work properly. Was I addicted to replacement therapy when it was prescribed for me? Was I in withdrawal when my therapy was changed from Synthroid to generic levothyroxine? Is a person with no thyroid addicted to replacement therapy? Merely dependent? Neither? Both?
Would a person with no thyroid be able to go through rehab therapy and successfully stop requiring thyroid medication (poor historical success rates for substance rehab aside)?
Addiction behavior such as hiding consumption and denying obvious usage don’t occur in all dependency situations.
Also, a person trying to obtain and consume thyroid replacement hormone in order to lose weight, for example, might have neither an addiction nor dependency. “Drug abuse” is a rather vague term that could include such legal practices as off-label prescribing done correctly by some medical practitioners and incorrectly by others.
When my father was dying of metastasized prostate cancer, I wished for every sort of addictive anesthetic pain killer on the planet for him. My mother was afraid he’d become addicted. Who cares, at that point?
I was wondering if you had a link to your definition or would identify which community held that definition is all.
If the problem stems from RedOrbit’s bad-job rewrite of the Associated Press article, then RedOrbit might benefit from reading yours and Arabella’s threads, think? I do.
Hi Parin,
We have quite the discussion going here. You are making some good points. It appears that drug dependence, drug addiction, and drug abuse are not clearly defined and are sometimes used interchangably. More on this later.
One good point to be noted in the article is that even during medication some drugs like caffeine, or prescription drugs cause addiction. Really nice article that you came up with. Good luck.
Hey, nice tips. Perhaps I’ll buy a bottle of beer to the person from that chat who told me to go to your blog
I must say great article and well thought of as some migraine articles are the same but this was a good solid read!