Can Addiction be "Cured"

[longhornfan1]

So, I am a recovering addict. I like to think of my addiction as "acute" "in remission" or dare I say it "cured".

I never tried a drug until I became a nurse. I didn't take them simply because they were accessible. I took them initially after a surgery for pain and then I took them because my body craved them so intensely that I would stoop to any level to get them.

I made my decision making "drug focused". Every action I took could be related to finding the drug, getting the drug and using the drug. I worked in the ICU and used 10 mg Morphine vials multiple times for post-op patients.

When a patient comes out of surgery it is really fast paced. The process of signing out and then wasting each unused drug took precious time away from patients. Why waste 8 mg's of MS when you will probably be giving an additional 2 mg's Q 10 mins for the 1st hour post-op anyway. So, you would give 2 mg's and put the vial in your pocket and pull it out each time you needed it until the patient was comfortable. Then you would chart the doses and waste what was left with another nurse.

One morning when I got home from work, I had forgotten to check my pockets. There it was. 6 mg's of MS. So, I set it aside and planned on taking it back on my next shift. But I had to put it someplace safe so no one would see it. What would they think.

It happened over and over again, intentionally, maybe, maybe not. Never used it, just put it in the drawer. I think I was afraid to use it cause what if I had a reaction? Or took too much and my kids found me on the floor unconscious?

One day, I put it in my hip. I felt like I was energized. I got so much done at home that day. After about a month of IM Demerol and Morphine, I had a patient on dilauded.

Took the excess drug home........along with an insulin syringe. I must have tried for 30 minutes to find a vein. I can find them blind-folded on my patients, but it is more difficult when your doing it upside down. After another month, I was shooting MS and demerol 4 or 5 times a day. But I did not believe I was an addict.

It all started with the Lortab after my tonsillectomy. I felt efficient, loving, attentive, smarter and focused when I took opiates. I didn't have to use every day. I was PRN so I would go a week without working and without using. I went on vacation for 2 weeks and didn't have any problems.

When I came back I worked 1 shift, took some dilauded and used it when I got off. I was called in the next day, I thought to work a shift, and was confronted by the DON, HR and several Admin nurses. I denied diverting but said I had partied while on vacation and would probably test + on the UDS.

Ignorant as I was, I gave them the urine and went home totally freaked out. I knew it would be positive and could not begin to imagine what would happen next. Looking back, I should have just quit and dealt with "suspicions" of diversion instead of giving them a dirty drug screen. But I didn't know I had a choice.

I broke down and told my husband that I was suspected, tested and probably terminated for using. But I didn't tell him what I used or that I was diverting. Told him it was Lortab, but I didn't have a current RX for it. So, when I was terminated and reported to TPAPN, I had to finally tell him what really happened. He reamed me up and down. Not supportive, did not recognize a "problem", just called me a junkie and was more concerned that I had potentially screwed my career. Our marriage is fine, believe it or not, and we only bring it up when we are really angry.

I have been sober since June 2 2006, the day after I got caught. Been through treatment, meetings and so on. I am working in LTC and have access to Lortab, MS tablets and Roxinal. Do I have cravings or feel compelled to take them? Nope. Did I learn my lesson? Yep.

But if you ask the professionals if I am "cured" they say there is "no cure". Once an addict, always an addict. But why? If I never did drugs until they were prescribed and have quit without issue and have proven my ability to be around the same drugs that I was addicted to?

Simply because I am the child of an alcoholic, the sister of an addict and the daughter of an undiagnosed and untreated mother with depression and bi-polar. Since I was molested as a child and my father died when I was 16. Since I slept around during high school so I could avoid the abuse at home. Since I dated men twice my age looking for a father figure until, Thank GOD, I met my husband and became a responsible adult and a mother.

Do all of these characteristic combined with the exposure to and subsequent physical addiction to Lortab define me as an addict for the rest of my life. Does that mean AA and NA meetings forever? Does that mean I can't drink at parties and dinner with friends because I might relapse and start using?

Someone please explain this to me. All addicts deny the addiction at some point in recovery, but don't people recover from the physical addiction and are strong enough to make the right choices when confronted with similar situations? HELP!! Thanks

[zuzi]

Good point Belfegor! Longhorn with the risk that you will not like my point, please go for therapy . You don't ask do it! I saw couple of bad cases of addicted nurses, one much twisted than another, some young, some old, some admiting that consume drugs, some no, but all of them never recognizing that are addicted and need treatment. Do it for you, and for your childs if you have ones, just do it Longhorn, don't ask, just do it, all of us we are here to support you and never ever you will be down. If now is hard for you to belive in your self, belive in us, all these people are here to be with you, just to do it and don't ask too much or think too much. A lot of love Zuzi :heartbeat:heartbeat

[Saifudin]

I don't believe anyone on this thread has sought to be malicious in their opinions, but with such 'self-disclosure' on an open forum and the seriousness of the actions as well as the history of our colleague (which was given after the opinions began), some of the mostly well thought out comments may be hard to accept, particularly with a certain amount of denial that seems apparent.

Whether the history given constitutes addiction or not, at this point, is really not important. What is important is that significant events have occurred that place our colleague at risk and the fact that she chose to share such private information would seem to suggest that she is still seeking some type of guidance.

I like the rest of you who have taken this issue to heart and have offered kind words of support, and have also suggested additional follow up, with a professional who can help to work through the serious issues our colleague has experienced throughout her life, with past drug use part of that.

[lpnflorida, LPN]

I was taught and believe addiction is never cured, it can however be in remission by the person's not using,drinking etc and working a program.

You asked if you can never drink I can see where you would ask that question as you had difficulty with drugs not alchohol. Personally I would avoid anything which might cause that so called slippery slope. Addiction as you probably have already read throughout the posts is clever, it is devious and it is not unheard of for a person to change/switch from drug of choice to something else. It can be to not even a drug so to speak. It can be to food, it can be to relationship. shopping etc.

I wish you well in your future.

[Magsulfate, BSN, RN]

i don't believe anyone on this thread has sought to be malicious in their opinions, but with such 'self-disclosure' on an open forum and the seriousness of the actions as well as the history of our colleague (which was given after the opinions began), some of the mostly well thought out comments may be hard to accept, particularly with a certain amount of denial that seems apparent.

whether the history given constitutes addiction or not, at this point, is really not important. what is important is that significant events have occurred that place our colleague at risk and the fact that she chose to share such private information would seem to suggest that she is still seeking some type of guidance.

i like the rest of you who have taken this issue to heart and have offered kind words of support, and have also suggested additional follow up, with a professional who can help to work through the serious issues our colleague has experienced throughout her life, with past drug use part of that.

i agree with this.

i have sat here and read through this whole thread. and i see a painful pattern.

-first the op gives her story and reasoning,, then asks for advice.

-then, the op gets very good advice.

-next, the op posts again with denial, reasoning, and pointing blame, all the while reiterating her story and asking for advice.

-the op gets more wonderful advice and suggestions,,

-then she comes back again telling everyone not to judge her, even though she wanted honest opinions and an open minded answer. and she continues to be in denial, wanting only for someone to tell her that she is not addicted, she doesn't want that stigma.

all she needs is one person to tell her that she doesn't have a problem, that she was never addicted.

i don't know what to say here. i don't think there's anything else i can type that would help the op understand what is going on. can't she see what everyone else is seeing? no, i don't think so. there has been some wonderful advice given here and in other forums to this same member, posting almost the same question in the nursing recovery forum.

i feel that she didn't get the answer she wanted there, so she came to this thread and asked again. that leads me to believe that she is desperately seeking help,, i just don't want to believe that she is desperately seeking an answer that she is not an addict. but, she is. there's no getting around that fact. i see it so very clearly here.

i seriously believe that the op needs counseling. that continuing to believe everything is perfect again and she never had an addiction is denial in a dangerous form.

i'm not saying all of this because i don't care, if that was the case i would have passed this thread by and never even took time to comment on it. i have seen what addiction and denial can do to a nurse firsthand. my experience is not that much different than the op, the only big difference is that i admit that i am an addict. i take steps everyday to make my life better, but i would never believe that i am cured. i am not.

okay, i will give one example, (and there are many more) of how the op has showed her denial.

"i took what was prescribed, until they ran out. that's it. i did not go doctor hopping or er bouncing for more meds. "

but in her very first post she says

" i made my decision making "drug focused". every action i took could be related to finding the drug, getting the drug and using the drug. i worked in the icu and used 10 mg morphine vials multiple times for post-op patients... "

there's one more thing i would like to say. in one post, the op says...

"once an addict, always an addict. but why? if i never did drugs until they were prescribed and have quit without issue and have proven my ability to be around the same drugs that i was addicted to? "

you did not "quit without issue". you were busted at work for stealing iv narcotics. end of story. you are an addict because of many things, but one of the defining characteristics of an addict is stealing narcotics to get their fix. you did it, and you can't take it back. as painful as it might seem to you, it is what you did, and you suffered the consequences of it. those consequences could have been worse, you could have been convicted and sent to prison. you were lucky.

i truly hope that you can live the rest of your life without using again, but hope doesn't cure addiction. hard work, counseling, abstaining, and understanding your disease are big steps to remission.

[jackstem]

Longhornfan1,

We've had some brief discussions in the Recovery forum. I understand your struggle with accepting the disease concept of addiction...and alcoholism is addiction. I'll be posting more on this later this evening as I am getting ready to travel to an anesthesia conference where I'll be helping the KYANA peer advisor man the Peer assistance and Wellness booth. In the meantime, follow this link to read an excellent overview of the disease concept of addiction.

Don't stop reading and studying about the disease. It's becoming more clear that addiction has an extremely strong genetic component that becomes active when mood altering substances are ingested. It can take years for the gene to "trigger", or it can happen very quickly. It depends on the substance, the person, time of exposure, environmental variables, etc.

http://www.nida.nih.gov/about/welcome/aboutdrugabuse/chronicdisease/

Hang in there!

Jack

[Magsulfate, BSN, RN]

This is a fantastic quote from Jackstem, he is an amazing person and an asset to the recovering health care professional community. I received permission from Jack to post this here and I think it hits the nail on the head as far as the stigma of being labeled an addict.

I'll leave it at that, and post this.

Research seems to be pointing to genetics as the major component for the development of addiction. Substance abuse can no doubt cause significant problems in a person's life, even kill them (and others around them...DUI, domestic violence, accidents, etc.). But the difference between the addict (loses control over substance use or behaviors...gambling, sex, etc.) and the abuser (eventually has something happens that makes them decide to "get clean"). And right now the estimate for the general public is somewhere between 10 - 15% (depending on the study). The problem with those statistics is the under-reporting associated with the disease of addiction due to the stigma. People get so hung up on the statistics. Who cares if it's 10, 12, or 15%? This is the number one public health problem in this country and the "war" mentality isn't working. We need early recognition, intervention and appropriate treatment...appropriate in length and philosophy. This is a chronic, progressive disease that we are treating as an acute problem that people expect to be "fixed" after one treatment attempt. The person leaves treatment and goes back to the places and people they used with...live in the same toxic family situations, and then everyone is surprised when the addict begins using again. We don't expect that from other chronic, progressive diseases like cancer, CAD, HTN, diabetes, asthma, COPD, etc.

It's clear what we're doing isn't working. If things don't change people will just keep dying...after they ruin themselves and those around them. And the attitude of health care professionals is hindering, not helping the situation. All you have to do is read some of the judgmental, inaccurate, unscientific comments on this web site and other nursing sites to see how much work needs to be done. If nurses and other health care "professionals" can't or won't accept the science that's been discovered over the past 2 and a half decades, how can we expect politicians, police, and the general public change the way they look at this disease.

[Saifudin]

What Jackstem stated is the prevailing thought and understanding of addiction based on scientific discovery besides several decades of observations from people in the field.

It is extremely important that health care professionals develop a working knowledge of abuse and addiction, particularly of use-to-abuse, in order to intervene early.

An attitude of a 'weak will' or 'weak faith' is really counterproductive. I am a Muslim and entered the addiction field in Saudi Arabia, not in the States. I initially refused my current position in 1995 when it was offered because I said, "I don't like working with addicts in the States; I sure won't like it in Saudi Arabia". I believed Saudi Arabia was a 'holy land' (some of it is) and could not fathom drugs in the place where Islam began and the home of the two holiest cities in Islam, Makkah and Madina. But, 3 months after the offer, I did accept it and its been nearly 14 years. I did not consider myself as a addiction professional for the first 12 years or so, and I'm not sure why. I was in denial until sometime last year when I realized how much time has passed, how much I had come to understand about addiction and how important this field is in nearly every society. And, its not just drugs and alcohol that people get addicted, however, the behavior patterns are basically the same and the treatments as well.

If anyone would be judgmental it would be us Muslims. Alcohol and all forms of intoxicants are 'haraam' or unlawful by God, not man. It is not a simple thing to be drunk in a country like Saudi Arabia. No bars, no alcohol sold openly. But it is here.

Alcohol was present in the early days of Islam (and for hundreds of years before it). In fact, the Arabs loved alcohol and would recite intense arabic poetry during bouts of drinking. It was so deeply ingrained in the culture that the verses of the Quran forbidding alcohol were not revealed until 17 years after the Prophet Muhammad was chosen to begin his mssion of establishing Islam in order for the early Muslims to develop a strong faith that would allow them to give up certain habits.

The Prophet (peace and blessings of Allah be upon him) was merciful with those who drank and who were addicted while also carrying out punishment for those who used but not in a vindicative manner. Today, people are also punished for using drugs and alcohol. These are part of the negative consequences of using but treatment is also extended to them.

So, I have learned that drugs and ETOH are what I call "equal opportunity destroyers". Doesn't matter who or what you are. I have seen many Muslims return or discover their faith after treatment; some after many attempts at treatment and I have also seen some clean and sober for 7, 8 or more years slip and lapse but get back on in the saddle (so-to-speak, and yes, sometimes a camel saddle) and carry on with their lives. Some of these men are counselors, trained in our hospital. They started to think they were 'cured' and had beat their addiction and that was the first step towards relapse.

Cure or not, and I personally don't believe addiction just goes away. It remains a permanent part of a human being; a part that went awry. I have seen the courage it takes to admit it especially in people who come from families and societies that seek nearness to God through faith and righteousness. The guilt and shame is intense but once they admit their addiction and practice 'acceptance' they have taken to first steps, often baby-steps, towards a healthy recovery.

"Be merciful to those on earth, so the One in Heaven will be merciful with you" Prophet Muhammad

[Atheos]

I think everyone is panicking. Longhorn had a valid question.

There IS a significant difference between abuse and addiction...

Viva, you talk about alcohol. That you can NEVER have the alcohol again. That's addiction plain and simple.

I, however, was drinking alcohol like a fish from 13 to 21ish. By the time I stopped I was drinking fifths like people drink cans of beer. I drink now but there is no pull, no craving, not inability to stop, no bad consequences, no drinking to illness.

I was an alcohol abuser. Despite YEARS of drinking EVERY day in the end I was never an alcohol addict. I was an abuser.

Smoking though... I am addicted to smoking. It's a completely different monster than the alcohol. The cigarettes have me like alcohol had you Viva. But the alcohol NEVER had me. It just seemed like it did.

There is a big difference between the two words. Not merely 'semantics.'

As an aside, my shrink in those days INSISTED I was an alcoholic. Bleh...

Of course, I am in no way condoning any behavior by the OP. Merely pointing out that little tidbit that shouldn't be overlooked.

[jackstem]

Yes, yes, yes!!

There is a huge difference between substance abuse and chemical dependence. While the two are closely related, the chemically dependent person loses the ability to control their use as the disease progresses. There is obsession with obtaining the drug if they don't have it, and compulsive use when they do have it. There are repeated attempts to "control" or curb their use. While they can be successful for varying degrees of time, there is always an eventual return to use. While they may be able to limit there use at times, they eventually return to use that ends with significant intoxication or until the supply of substance is used up. Then the whole cycle begins again.

MOST folks with an abuse problem aren't likely to divert drugs from their plave of employment. I didn't say they never divert! But progressing to the point of diverting is a pretty significant sign that they have crossed the line into addiction (or are really, really close).

Someone who diverts and injects drugs, especially intravenously, have crossed the line to addiction. Someone who is not an addict doesn't steal schedule II substances and inject them. INJECTION of controlled substances not prescribed is considered to be a definitive sign of addiction by addictionologists (if we were in court, the term would be Res ipsa loquitur, which means no additional proof be provided for a "guilty" verdict. In other words, because the facts are so obvious, a party need explain no more).

Because of the stigma regarding this chronic, progressive, fatal if not treated disease, people delay assessment and treatment until they can no longer be ignored. By that time it has progressed to a serious stage, making treatment more difficult and the risk of treatment failure and serious and repeated episodes of relapse very likely. My goodness, if we delayed treatment of diabetes, hypertension, coronary artery disease, cancer, and other chronic, progressive, ultimately fatal if untreated disease like we do for chemical dependence, there would be a horrendous outcry with marches on hospitals, state capitals and Washington DC to protest the incompetence and unethical manner in which these patients were being mistreated! But when it comes to addiction, we lose all objectivity and ignore the science, and find it acceptable to ignore, under-treat, and allow people to deteriorate because "they did it to themselves!"

No one wanted to believe the Earth wasn't the center of the universe, or that diseases were caused by little organisms we couldn't see. They believed Leprosy, epilepsy, and other diseases were punishment by God or possession with demons. Science has proven the neurological basis of addiction and other psychiatric illnesses, yet society AND many in health care still don't really "buy it". Why else would nurses (and I'm speaking from experience with my ex-wife, my sister, and several colleagues I worked with) continue to try to wean themselves of of their SSRI's because they didn't want to take these medications for the rest of their lives, yet have no problem taking antihypertensives, statins to lower cholesterol, insulin, bronchodilators, and other medications forever? The stigma of neuropsychiatric dysfunction is so strong people would rather suffer the consequences of not treating the disease. Where does stigma come from? Ignorance. When you study the research and grasp the basic pathophysiology of addiction, it becomes clear that it is a disease. But as health care professionals, we're expected to base our actions on science, not belief.

[Tweety, BSN, RN]

Many an addict has died, ruined their career, lost their health, lost their families, gone to insane asylums, or jail trying to prove to themselves "I'm not an addict", "I only abuse", "Sure I might have had a little problem with stealing drugs, but I'm not an addict", "I can quit anytime I want to", "I only use on weekends", "I really need the drugs for pain"., "I'm really under a lot of stress right now, but it's not really a problem", "So what if I steal drugs from patients, it's not like they needed all of that morphine"....................

If it looks like poop and smells like poop, it's probably poop.

[Atheos]

Many an addict has died, ruined their career, lost their health, lost their families, gone to insane asylums, or jail trying to prove to themselves "I'm not an addict", "I only abuse", "Sure I might have had a little problem with stealing drugs, but I'm not an addict", "I can quit anytime I want to", "I only use on weekends".

If it looks like poop and smells like poop, it's probably poop.

The point is that 'abusers' aren't stealing drugs. That would be an addict.

Even with cigarettes. I abused long before I was addicted. The behavior in each stage is different.

I am also neither claiming that abuse doesn't LEAD to addiction nor that some people aren't addicted immediately.

[Tweety, BSN, RN]

The point is that 'abusers' aren't stealing drugs. That would be an addict.

Even with cigarettes. I abused long before I was addicted. The behavior in each stage is different.

I am also neither claiming that abuse doesn't LEAD to addiction nor that some people aren't addicted immediately.

I wasn't disagreeing with you. There's no exact science.

Not all addicts steal drugs. You don't steal cigarettes do you?

The big difference between someone that abuses and someone that is an addict is that the abuser finally recognizes there's abuse and stops easily. The addict continues to deny there is a problem and doesn't stop despite the consequences. Or they stop, get their act together and relapse.