USER VS. ADDICT

Rush Limbaugh, ordinarily not one of my favorite people, is to be
congratulated on his frank admission of a drug problem and announcing his
intention to seek treatment.

Unfortunately, media commentary on the situation has used the rather
nonspecific term "addiction" without clarification.

When the cause of chronic pain is not amendable to cure and pain remains
chronic in spite of alternative methods of treatment, various narcotics are
the appropriate treatment. Most chronic pain patients use the medications
as directed and do not require constantly increasing doses to obtain relief.

They respect the hazards of overdose and rarely misuse the medication for
recreational purposes. They may become dependent on of the narcotic, but
their dependency is not technically different from that of some diabetics
on insulin. It is a dependency that enables normal life rather than
preventing it.

Drug abuse is different, in that the drug is used for recreational or the
relief of psychological miseries that would be more appropriately treated
by "non-abusable" medications, such as anti-depressants. These individuals
use steadily increasing doses far beyond any reasonable need in a doomed
effort to find oblivion or bliss rather than address the psychological
problems causing their distress.

It is the latter group who take advantage of unwary physicians to obtain
prescriptions for which there is no legitimate indication and whose
perceived need for ever larger doses leads them to deal in the black
market. It is these people who are appropriately described as addicts.

Media's failure to discriminate these groups has caused confusion for
patients. Too many refuse needed pain relief because of the mistaken belief
that drug abuse will inevitably follow. Limbaugh's announcement and the
subsequent media discussion have missed the opportunity to educate the
public about the difference.

Dr. C. Brooks Henderson, Dunnellon