Posts Tagged ‘addiction’

I was eight on the rainy April day that Grandma died. She woke, served up Grandpa’s usual breakfast, fed the cat and went to the porch for the morning paper. She didn’t return. Grandpa found her reaching for the door, sharing her love for him with her eyes as she took her final breath. I knew something was wrong the minute my mother answered the phone and fell into a chair with my little brother clinging to her leg. I remember dad taking the phone from her hand but the rest of the day was a blur of hospitals, family and men in suits shoving endless forms at Grandpa. Mom put on a brave face, but cried when she thought she was alone. She wasn’t ready to lose her mom. A funeral was arranged and family gathered. All I remember after that is how sad and alone Grandpa looked.
After the funeral things went back to normal, my brother and I went to school and dad went to work. The only thing different was my mom spending her days with her father, going through legal papers and personal items. She looked tired and sad at the end of the day and I didn’t know how to make things better. Three days after the funeral I came home from school, dropped my backpack on the floor and headed to the fridge. I grabbed a soda and pudding snack before settling at the table. The house was still quiet, dad was at work, my little brother was with a sitter and mom was with her dad. I listened to the old mantle clock tick off the minutes as I mindlessly shoveled in the pudding, wondering if life would ever be normal again. Mom hadn’t even opened the mail, there was a pile at least two inches thick sitting on the table. Sliding the pile closer I picked up envelope after envelope. Credit card offer, electric bill, cable bill, val-pak coupons, sale flyers, insurance bill, nothing special. Then I saw it, the bright red envelope with my name scrolled across the front.
She remembered her heart skipping a beat as she pulled it from the pile, looking it over before she got the nerve to slide her thumb under the flap. She had never received real mail before and wanted to do it right. Proud that she had barely frayed the glued flap she slowly pulled out the contents. It  was a card. On the front was a cartoon woman with gray hair,  her freakishly long arms wrapped around a large family of children and adults, pulling them close to her. With trembling fingers she opened the card, it read “Happy Birthday! You are loved today and always.” It was simply signed “your family,” but she recognized the handwriting, it was Grandma’s. Picking up the envelope she noticed that the return address was that of her grandma’s house. Pulling the card to her chest she let herself cry for the first time since she died. It was a long, hard cry that left her drained, but the card had felt like Grandma reached out with one last hug. The rest of her family came  home, they ate dinner and she went to bed, but not before securing the card, in the envelope in her diary.
Summer came and went that year and life was a new normal. It wasn’t until fall that my mom looked sad again. When I asked her why, she said that her mom’s birthday was coming up and she didn’t know how to handle things with her dad. I thought about that a lot at school and at home. Grandpa had looked so lost lately I wanted to do something to make him feel better. Then I remembered the card. it made me feel better, maybe it would make him feel better. I raced home after school, dug out the card and put it envelope and all in a new envelope, carefully wrote out his address and took a stamp from mom’s desk. My little brother followed me to the porch.
“Where ya going?” He asked.
“To the mailbox.”
“Why?”
“To mail a letter?” I snapped.
“To who? What kind of letter?” He persisted.
“None of your business squirt!” I shouted, running the last few feet.
I remember feeling a bit bad over snapping at my brother and taking his hand on the walk home. He seemed to accept that as an apology. Days passed as I wondered if my gesture would make grandpa feel worse instead of better. Then one Saturday morning the doorbell rang, I heard Grandpa ask to see me. I entered the hall and he pulled me into his strong arms and whispered “thank you” in my ear. He said it felt like grandma had come for a visit.
That was ten long years ago, I’m nineteen years old and a lot of life had passed under the bridge since then. Family gatherings stopped, no more Christmas Eve dinners at Grandma’s, no more forced Sunday dinners, no more summer camping trips arranged by Grandma. Grandpa died two years back, I missed the funeral. My parents live their life and have all but given up on me. My little brother, set to graduate high school this year, is a computer nerd devoted to technology, there is little room for humans in his world. And me? I have a life, not the life my parents planned. I work various bar jobs, pole dance when Moe needs a fill in dancer and am not above a good night of drinking. I may or may not, use my own money to pay bills, but if a customer is dumb enough to leave  his wallet on the bar while he attends a lap dance, is that my fault?
I served another round to table four, slapped away Dwayne’s hands at table two and made my way to the kitchen. My shift was over, all I wanted to do was gather my tips, get a few drinks and head home. A few drinks turned into ten and getting home was a bit tougher that I thought. I tossed my heels into my locker, fell into my sneakers, tied what I thought was a passable bow and slapped the back door open, stumbling into the alley. I crawled to my feet as the scenery spun around. I focused on the neon drug store sign as I knew that was the direction I need to take. I stumbled down the walk, feeling good, sure I was looking normal. Sure, I bounced off the wall a few times, and into a gentleman who called me a drunk as he put me back on my feet, but I was doing ok. I went another block and found myself on my knees, my forehead on a fire hydrant. Phew, if I had fallen a second later, that could have hurt! Back on my feet I gripped the smooth window of the diner until I felt the rough brick, then turned right. Only twenty feet more and I would be home. The cement block felt rough under my fingers as I used it to guide my way. Soon I felt the splintered wood frame around my door. Diving into my pocket I fumbled my way through lip gloss, bent lottery tickets and old receipts until I found my keys. It took a few tries, but I got that sucker in the slot and the lock clicked open. I clung to the wall as I made my way up the stairs. I remember trying to put the key in the upstairs lock, but I must have failed.
A ray of morning sun, creeping through a badly cracked window cruelly pried my eyes open. I wiped the spit drying at the corner of my mouth and rolled to my side, realizing that I was on the filthy tile outside my apartment door. Rolling on my back I started to rise, stopping when I saw the flash of red. Sitting up I moved back to rest on the door as I inspected the envelope. I tore it open just as carefully as i had the first time. It was a card, with an elderly woman with long arms embracing her family. Inside it said, “Happy Birthday! You are loved today and always.” It was simply signed “your family,”
Pulling out my phone, I checked the calendar, it was indeed my birthday. Grandma had reached out again. Putting the card in  her pocket she entered the apartment, packed her meager belongings and bought a bus ticket home.

When the memories came, they tore at her stomach with icy fingers and hijacked her mind. It didn’t matter if she was hunched over a keyboard, or in a green room preparing for a T.V. appearance. The terror would suck her into the seedy, addiction fueled  violence that was her youth.  A time when her mother lived in the bottom of a bottle and her father, who refused to admit he was part of the problem, expected her to care for the house, and her mother. If she failed to meet his standards, she was rewarded with cigarette burns and beatings. She was ten when one of his lessons left her bleeding, with loose teeth and a broken rib on the bathroom floor.

Huddled on the bed, she waited for him to pass out before slipping out the window. Wracked with pain, she made her way to the local hospital, after that, things got blurry. Confusion reigned as they tried to find her parents and more importantly, who would pay the bill. Eventually they called in a social worker, who, after one look at the battered girl, set the wheels in motion to secure a better life for her.

Reluctant at first, and afraid of her father’s reaction, she begged them to let her go home, but her mentor refused, eventually making her see that her parents needed help and that what was good for her, was not one of their priorities. After bouncing in and out of a few foster homes, she met her new parents and discovered a talent for writing that they encouraged. Over the years, her body had healed, but her mind wore band-aids, ready to fall off at any time.

Now, she was a successful author. Two of her books had been adapted for the big screen and she was working on a Broadway play. At the age of thirty-three she had met a man who just may be the one she would grow old with. She had money, a great house and a few friends she could count on.  Life was good. Her mother had died years earlier, but her father had tried to make contact a few times, hoping to cash in on her fame and fortune, she ignored him.

Jumping as the intercom sprung to life, instructing her to head to the set, she thought about her organization and the kids and women it would help. Vowing to get as many of them out of violent situations as she could, she took a deep breath and headed to the stage to sell her latest book, the one with fifty percent of the proceeds going to the “Kids First” organization. She rose from the ashes, now it was time to help others fly!

It’s once more time for the weekly photo prompt exercise known as the Friday Fictioneers. Thanks to Madison Woods and all of her generous photo contributors, a lucky group of us get the chance to read, or write our own 100 word stories based on the prompt. Mine is below the picture, the link to find the other stories or directions for adding your’s is below.

Poised near the alley, she was determined to find the bitch who took her kids and make her pay. So what if she used a little meth, drank now and then and dated, that didn’t give that social worker the right to take her babies! Was it her fault the brats missed school, or that the boy couldn’t stay on his feet when she smacked him? He needed to toughen up.

When the wind flung sand in her face, she threw up a hand, but it wasn’t enough to stop the onslaught. The debris gained mass and speed, cutting her exposed flesh as her feet left the ground. The last thing she saw was the women’s face peering out the window as she thanked her guardian.



 

This is a repost of a study I found.

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Opioids: Addiction vs. Dependence
by Karen Lee Richards, ChronicPainConnection Expert
One of the greatest obstacles chronic pain patients face in their quest for adequate pain relief is the widespread misunderstanding of the difference between physical dependence on a drug and addiction. Many patients, the general public, and sadly even some physicians fear that anyone taking opioid medications on a long-term basis will become addicted. As a result, pain patients are often labeled as “drug seekers” and stigmatized for their use of opioid medications. Worst of all, their pain frequently remains under-treated.
Understanding the Terminology
Before we can adequately discuss this topic, it is important to clearly define the terms we will be using.
Addiction is a neurobiological disease that has genetic, psychosocial, and environmental factors. It is characterized by one or more of the following behaviors:
• Poor control over drug use
• Compulsive drug use
• Continued use of a drug despite physical, mental and/or social harm
• A craving for the drug
Physical dependence is the body’s adaptation to a particular drug. In other words, the individual’s body gets used to receiving regular doses of a certain medication. When the medication is abruptly stopped or the dosage is reduced too quickly, the person will experience withdrawal symptoms. Although we tend to think of opioids when we talk about physical dependence and withdrawal, a number of other drugs not associated with addiction can also result in physical dependence (i.e., antidepressants, beta blockers, corticosteroids, etc.) and can trigger unpleasant withdrawal symptoms if stopped abruptly.

Tolerance is a condition that occurs when the body adapts or gets used to a particular medication, lessening its effectiveness. When that happens, it is necessary to either increase the dosage or switch to another type of medication in order to maintain pain relief.

Pseudoaddiction is a term used to describe patient behaviors that may occur when their pain is not being treated adequately. Patients who are desperate for pain relief may watch the clock until time for their next medication dose and do other things that would normally be considered “drug seeking” behaviors, such as taking medications not prescribed to them, taking illegal drugs, or using deception to obtain medications. The difference between pseudoaddiction and true addiction is that the behaviors stop when the patient’s pain is effectively treated.

Can a chronic pain patient become addicted to opioid drugs?

Although most chronic pain patients who take opioids on a long-term basis will become physically dependent on them, very few will ever become addicted to them. The rare few who do develop a problem are often highly susceptible to addiction due to a genetic predisposition. In a review of 24,000 patients who were medically prescribed opioids, only seven could be found who got into trouble with them. So a chronic pain patient becoming addicted to opioid medications is definitely the exception rather than the rule.

Opioids: Addiction vs. Dependence

How can you tell if someone is addicted to an opioid drug?
People who become addicted to opioid drugs usually report getting a feeling of euphoria or being “high.” They soon need increasing amounts of the drug to maintain that same high feeling. Unfortunately, this frequently leads to an ongoing and often desperate search for more of the drug through whatever means possible – legal or illegal.

Some behaviors that may be suggestive of possible addiction include:
• Taking medications more frequently or at higher dosages than prescribed.
• Ingesting drugs in ways other than directed, such as crushing, snorting, or injecting.
• Frequent reports of lost or stolen prescriptions.
• Doctor shopping.
• Using multiple pharmacies.

Following are some of the key differences between addicts and pain patients:
Addicts Pain Patients
Addicts take drugs to get high and avoid life Pain patients take drugs to function normally and get on with life.
Addicts isolate themselves and become lost to their families. When pain patients get adequate relief, they become active members of their families.
Addicts are unable to interact appropriately with society. When pain patients get adequate relief, they interact with and make positive contributions to society.
Addicts are eventually unable to hold down a job. When pain patients get adequate relief, they are often able to go back to work.
The life on an addict is a continuous downward spiral. When a pain patient gets adequate relief, their life progresses in a positive, upward direction.

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Sources:

The American Academy of Pain Medicine, The American Pain Society and the American Society of Addiction Medicine. (2001). Definitions related to the use of opioids for the treatment of pain. Retrieved December 1, 2008, from American Pain Society Web site: http://www.ampainsoc.org/advocacy/opioids2.htm
The National Institute on Drug Abuse. Addiction vs Dependence. Retrieved December 1, 2008 from Our Chronic Pain Mission Web site: http://www.cpmission.com/main/addiction.html
© Karen Lee Richards 2008
Updated 12/1/2008