Is someone really an addict if they have been prescribed medication for pain and can no longer function without the medication? This is a question I am often asked. They are certainly dependent on the painkiller but they are not necessarily an ‘addict’. They may well need clinical help coming off the substance due to the physical withdrawals they may experience. If they have maintained using the painkiller as prescribed and have not varied from the prescribed regime I would suggest they are not an addict in the sense of addiction being a disease. The addiction as a ‘disease’ model states that an addict will have lost the ability to control the use of the substance: that once they take the first one they will be physically compelled to consume more alongside being mentally obsessed to use more. Many people go into hospital and have to be treated with opiated painkiller. These patients as a rule do not go on and become ‘addicts’. They stop taking the pain killers, feel a little under the weather for a few days and then get up and carry on with their lives. It is those that cannot stop using once they have been given pain killers despite experiencing negative consequences that are ‘addicts’. Doctors are prescribing more and more opiated pain killers than ever before. Those that go on to become addicted to these opiated drugs end up facing many of the same problems as any other ‘addict’. They are not special and different and in some way ‘better than other addicts’ as is often the thought processes of people with addictions to OTC (over the counter) or prescription drugs. This thought process ties into their denial of the problem. Denial is one of the main characteristics of all ‘addicts’. They have moved into what is called non-medical use of OTC drugs and/or prescription drugs. The nonmedical use of a prescription or over-the-counter (OTC) medication implies that the user is using it for reasons other than those indicated in the prescribing literature or on the box label. The abuse of these medications is a national issue. Prescription medications are those pharmaceuticals dispensed by a pharmacist on the presentation of a prescription written by a physician, dentist, or other health care provider who is legally authorized to write prescriptions. OTC medications are pharmaceuticals that do not require a prescription and are sold on the shelves of markets, stores, and pharmacies.
Addiction to OTC medication and prescription medication needs to be treated in exactly the same way as any other addiction. For help with prescription painkillers please contact Victoria Abadi Therapies on 07983726647 or victoriaabadi66@gmail.com
Over the years I have devised a three tiered way of working with clients. Think of an iceberg divided into 3 parts. The top part of the iceberg is the bit that clients usually present in therapy with. They come to me stating that they are obsessively and compulsively using a substance or addictive behaviour, such as gambling or watching pornography. If they are using a substance such as alcohol or cocaine daily then the first thing we need to work on is stopping that behaviour so that they can become psychologically available for counselling. At this point the work that I may be doing with the client may look and feel more like advice and guidance rather than therapy. This is the bit that is visible. We will look at what support the client can access, what are the barriers to them accessing that support. Helping the client understand that life has to be better clean and sober than it is using or drinking. This looks and feels different to every individual but in my experience has to be about connection to their life and others in some meaningful form or other. It may be a connection to other recovering people, a connection with a hobby such as yoga, running or painting. Again this is more effective in making the client have a sense of wellbeing if they are connected to others practicing/participating in the same thing. I remember one of my clients describing to me the importance of having found her tribe. She had tried the 12 step model of attending mutual aid meetings but had not felt comfortable with this. She went on to use therapy weekly combined with yoga for the next 12 months. Within her yoga practice she met a lot of other likeminded people. She felt connected. She had found a place where she felt she belonged. Addiction more often than not takes a person to a place of isolation. I now understand isolation to be something born from a sense of shame and self-loathing. It doesn’t start out that way. It starts out as using substances on your own primarily so as to not be seen to using too much, not having to explain yourself, an underlying sense that the way your using is not quite right, maybe a sense of paranoia if other people are around, it may even be you just don’t want to have to share your stash. Whatever the reasons may start out as somewhere along the line something changes. That desire to be alone turns into a need to be alone. Facing other people becomes too difficult whether it be due to shame, embarrassment, social anxiety, depression, paranoia, psychosis and the result is the same – addicts spend more and more time alone due to need not want.




