like. When we are too close to a situation, those who care for us may provide perspective. If you feel resistant to doing this, just acknowledge the resistance and do it anyway. Don’t prejudge what others may say; just get their input. Input is necessary to accurately assess and diagnose, and as with any medical condition, you need an accurate assessment and diagnosis to effectively deal with your problems. So stay open-minded and get as much information about your situation as you can. If you feel the information is inaccurate, be sure to discuss this at a later time with a trusted person, a counselor, or a professional.
{ exercise 3.3 }
Am I Addicted to My Pain Medication? Self-Test __________
The following questions may help you make that determination. Answer yes or no for each question.
____ 1. Have you ever taken more of your medications or taken them more frequently than was prescribed?
____ 2. Have you ever used another doctor because your doctor wouldn’t prescribe any more medication or increase your dosage?
____ 3. Do you find yourself looking at the clock to find out when you can take your medication next?
____ 4. Have you used alcohol while taking prescriptions to enhance the medications’ effect, even knowing you were not supposed to?
____ 5. Have you ever used illegal drugs while taking prescribed medications?
____ 6. Do you have more than one doctor who is prescribing medications for you?
If yes, are those doctors aware of all of the medications you are taking?
____ 7. Have you ever gone to an emergency room to get additional medications because the ones you had were not enough?
____ 8. Have you ever run out of a prescription before you were supposed to because you used more than was prescribed?
____ 9. Did you ever think “as needed” meant you could use as much as you wanted to, when you wanted to?
____ 10. Have you ever lied to a doctor about why you needed another prescription filled?
____ 11. Have you ever exaggerated your reported pain level just in case you had more pain later or to get another or a stronger prescription?
____ 12. Did you have addiction problems before your chronic pain?
____ 13. Have you ever thought, “I can’t live without medication”?
____ 14. Have you ever gotten a prescription and lied to your spouse or other family or friends about it?
____ 15. Have you ever lied to your spouse or mate or anyone about how much medication you are taking?
____ 16. Are you taking prescription medication and supplementing it with over-the-counter medication?
____ 17. Are you taking other prescriptions to deal with the side effects of your pain medication, e.g., sleep aids, stimulants, antianxiety drugs, or Soma?
____ 18. Have you ever taken anyone else’s pain medication?
____ 19. Have you ever stolen, forged, or altered a prescription, or called in a prescription by impersonating medical staff?
____ 20. Have you ever crushed, snorted, or injected your medication or taken it in a way other than the way it was intended to be taken?
____ 21. Have you ever overdosed or needed medical help because you took too much medication?
____ 22. Have you ever experienced a blackout (memory loss) caused by medication?
____ 23. Have you experienced legal consequences as a result of taking your medication, such as a DUI or assault and battery arrest?
____ 24. Have you had a friend, spouse, or family member express concern regarding your use of pain medication?
____ 25. Have you ever taken pain medications to deal with other issues such as stress or anxiety?
None of these questions necessarily defines addiction, but if you answered “yes” to any of these, you should not rule out the possibility of addiction. The more “yes” answers you have, the greater the cause for concern about addiction. Do not use this test to judge yourself negatively; use it as part of a process of learning and examining that is necessary for success in pain recovery.
Problematic Drug Use (PDU)
For many of you with chronic pain, addiction may be too much of a stretch. However, you may find it helpful to look at your use of medications as being either problematic or nonproblematic. Even before a diagnosis of addiction is established, you may conclude there is problematic use that may or may not evolve into addiction. The following table will assist you in defining problematic use.
| Nonproblematic Prescription Drug Use | Problematic Prescription Drug Use |
| Pain is relieved or manageable with medications. | No appreciable decrease in pain. |
| No significant changes in functioning due to medication. | Significant decrease in functioning due to medication. |
| No significant effect on relationships; no concerns from family regarding use. | Ongoing relationship problems and concerns from family regarding use. |
| Able to work with no significant decrease in job performance. | Unable to work or significant impairment due to medication. |
| Stable or maintenance dose of pain medication. | Steadily increasing dose and frequency of medications with little or no decrease in pain. |
| Emotional stability and acceptance of any physical limitations. | Emotional instability and increasing lack of acceptance regarding physical limitations. |
| No significant cognitive impairment due to medication use. | Significant cognitive impairment due to use e.g., foggy thinking, difficulty concentrating, memory problems. |
| Using medications only for pain relief. | Relying on medications for emotional effect. |
{ exercise 3.4 }
Use of Medications __________________________
Write about areas in your life related to the previous chart where you are experiencing problems.
________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________
