Life as an Extreme Sport

The Daily [05-08-06] – Dependency vs. Addiction

If this looks familiar to some of the longer-time readers, well… it was a busy week. And besides, the original was pretty good in and of itself.

Dependency vs. Addiction
Publish Date: 2006-05-08

I meant this column to be about the idea of informed consent. It’s a subject both House and Grey’s Anatomy have covered in their last couple episodes; something I would call a coincidence if they hadn’t been doing this back and forth of show themes for two seasons now.

But one evening I managed to find myself on the Television Without Pity Web site, in theory rereading the details of those pertinent episodes of Grey’s and House, when I decided I wanted to read recaps from earlier episodes.

That decision led me back to a first-season episode of House titled “Detox.” The theoretical point of this episode was a teenager with bleeding of unknown origin, but the actual point was to examine the vicodin use of the main character, Greg House.

For the few of you who’ve managed to miss this show, the character likes to discover novel ways to take vicodin.

In his defense, he’s missing a good part of one of his thigh muscles and has severe nerve damage from various complications of a blood clot and surgery years before.

House is accused of being a vicodin addict, and is challenged to go a week without taking any. He accepts the challenge, and during the course of the show appears to go through withdrawal, going so far as to break his hand to force his body to pay attention to different pain.

The result? Everyone crows that House is a drug addict.

I don’t agree.

Addiction is a biological and psychological condition that compels a person to satisfy their need for a particular stimulus and keep satisfying it, no matter what the cost.

Dependence is a physical state that occurs when the lack of a drug causes the body to react.

Physical dependence indicates that the body has grown so adapted to having the drug present that sudden removal of it will lead to withdrawal reactions. This can happen with almost any drug.

House is in constant, chronic pain. The physical dependency on vicodin is one that allows the character to maintain a normal lifestyle.

To use analogy to illustrate the point, imagine that a normal, healthy person is akin to a full glass of water. Someone who is in chronic pain is only half a glass of water without pain medications.

Add in a bunch of ice cubes, and the person in chronic pain is brought back up to the normal and functional level of everyone else.

In the case of the addict, toss a few ice cubes in a full glass of water, and watch everything spill everywhere in a mess. That’s addiction.

The chronic pain person needs those ice cubes of vicodin on a daily basis to provide what the body needs to function, but it’s not a situation where they would actively seek out, need, or desire any more than necessary to achieve that state of near-normalcy.

Regular use of some medications is necessary for some people to live a normal life. A diabetic is not addicted to insulin, nor is someone taking medication to control high blood pressure addicted to it.

They are, however, dependent upon it, as a person in chronic pain is dependent upon their drugs to function normally.

Perhaps that’s the thing one needs to consider when weighing notions of addiction or dependency — the person who is addicted does not have improved functionality with their addiction, while the dependent person does.

The writers of House have been irresponsible in how they’ve portrayed the character of House’s dependency, and this causes a lot of grief for actual living and breathing people with chronic pain.

There is a stigma associated with needing pain medicine every few hours. This stigma, shame and fear prevents many doctors from properly treating pain, and prevents many people from seeking out the relief they need.