Pubdate: Wed, 22 Oct 2003 Source: Sun News (Myrtle Beach, SC) Copyright: 2003 Sun Publishing Co. Contact: http://www.myrtlebeachonline.com/mld/sunnews/ Details: http://www.mapinc.org/media/987 Author: KATHLEEN PARKER PAINKILLER USE DOESN'T MEAN ADDICTION Say what you will about Rush Limbaugh, he brought life to the party. His admission now to drug "addiction" caused me to say to a friend, "I feel sorry for him." Why? "Because I feel sorry for anyone who suffers addiction." If, in fact, he is an addict. The verdict is still out despite what the evidence suggests. Also, pain specialists are distressed that all the piling on following Limbaugh's admission of drug use may set pain management back 100 years. First, there's a difference between physical dependence on drugs and addiction. If you use legal medications as prescribed, you're unlikely to become addicted. Recent research shows that only 6 percent to 10 percent of all chronic pain patients on opioids become addicted. That's the same percentage as the general population that becomes addicted to alcohol or shopping or gambling. In other words, the risk for opioid addiction is no greater than the risk for other addictive behaviors and substances. The key to avoiding addiction to pain medications such as OxyContin, the opioid Limbaugh was taking, is presence of pain, according to Joan Wentz, an assistant professor and specialist in pain management at Jewish Hospital College of Nursing and Allied Health in St. Louis. That is, if you have pain and treat it with opioids, you're unlikely to become addicted, though you may develop a physical dependence. Dependence means simply that your body adjusts to the medication, and if you withdraw abruptly, you will suffer unpleasant symptoms such as palpitations and hallucinations. Addiction, on the other hand, is defined as compulsive craving and uncontrolled use despite harm. Whether this definition characterizes Limbaugh's situation is unknown. The number of pills he reportedly procured doesn't necessarily indicate addiction, Wentz says. He may have been in pain and, because of his body's adjustment, needed more medication to manage it. Wentz and others in pain management worry that people who need medication now will fail to seek treatment for fear of addiction, and doctors may hesitate to prescribe it when needed. In a recent bulletin to pain specialists, the American Pain Foundation charged the media with perpetuating "long-standing myths and misconceptions about pain management and pain medications" in its Limbaugh coverage. "When properly used, pain medications rarely give a 'high' - they give relief. And, most important, they allow many people to resume their normal lives," said the bulletin. The fact that Limbaugh could continue functioning in his career makes Wentz skeptical about his being an addict. As to whether he's a hypocrite, well, that's a tougher charge to dismiss. It's hard to swallow Limbaugh's punitive line for drug users when he tossed back OxyContin like M&Ms. Not surprisingly, Rush's critics are delighting in his humiliation, though some have leavened their comments with sympathy for his obvious pain. Fans and colleagues, meanwhile, have circled the wagons, trying to draw a distinction between Rush's addiction to legal medications to treat pain and those who become addicted to illegal drugs merely to get high. Sorry, but that doesn't wash. Limbaugh's fall from grace ultimately may be a blessing not only for him, but also for people who suffer pain and those who succumb to addiction. The message in the bottle is this: Suffering pain is not heroic, and becoming an addict is not a crime. - --- MAP posted-by: Perry Stripling