LIFE BEFORE DEATH #11 -- Dependence vs Addiction

"Dependence versus Addiction" Short Film 11 of 50 in the LIFE Before Death documentary series about the global crisis in untreated pain and the dramatic life changing effect palliative care services can deliver to patients and their families around the world. In this Short Film we discover that prolonged use of opioid medications is likely to cause physical dependence in patients and that this is a natural physiological response that should not be feared or stigmatized. Dr Kathleen Foley (USA) explains; "Patients chronically taking opioids will become physically dependent, but that's not psychological dependence or addiction. When patients with cancer taking opioids withdraw from their medications that doesn't mean that they're addicts, it means they're in withdrawal because they're physically dependent." Dr Jim Cleary (Australia) identifies that dependence is a normal physical response where the body is signaling that it needs certain medicines. By contrast, "Addiction and the psychological dependence we talk about is when people start craving these drugs and continue to use them despite documented harm." Physical dependence is a normal response, agrees Dr MR Rajagopal (India), who expects to see some side effects during withdrawal from opioid medications. "But that's not addiction." Dr Kathleen Foley provides an anecdotal patient case study to highlight the difference between dependence and addiction. "For more than the majority, I'd say ninety-five per cent of patients taking these medications, this is not about the use of these medicines for anything other than pain relief." Dr Daniela Mosoiu (Romania) explains that the way morphine works on patients with pain is quiet different to the way it works in a physically healthy and pain-free person. "It seems that pain is in a way modifying the chemistry and the way we react to opioids." "Research has shown that it's an infinitesimal percentage of cancer patients that become addicted," states Mary Callaway (USA). Mary Callaway and Dr Daniela Mosoiu indicate that it's a "ridiculous argument" to suggest that late stage patients in pain are becoming addicted or getting euphoric by taking medicinal opioids like morphine. "I never saw a cancer patient getting morphine and becoming euphoric," reflects Dr Daniela Mosoiu, "They get pain relief, they get a good sleep." "Of the thousands of patients I've seen, it does not change someone," states Dr Charles Von Gunten (USA). "If it works to control their pain, they're happy, they're symptom free, they're also adverse-effect free. If it doesn't work for their pain they stop taking it. If their pain gets better, they stop taking it." Dr Jay Thomas (USA) provides an analogy of another medication called Beta Blockers, which are medicines used to treat high blood pressure. "It turns out when you're on a Beta Blocker if you were to stop it cold turkey you would go into withdrawal... Many people would say that if you can go into withdrawal then you must be addicted, but that's actually not the case, that's a case of being physically dependent... I always tell patients, 'I don't think you've every seen people on the street corner prostituting themselves to get a Beta Blocker to treat their blood pressure'". Featuring Dr Kathleen Foley (USA), Dr Jim Cleary (Australia), Dr MR Rajagopal (India), Dr Daniela Mosoiu (Romania), Mary Callaway (USA), Dr Charles Von Gunten (USA), Dr Jay Thomas (USA). LIFE Before Death comprises 50 short films themed around pain control and end of life issues, releasing one a week for a year from May 2011. A feature film will be released in late 2011, followed by the release of a television documentary in early 2012. The project is presented by the Lien Foundation and produced by Moonshine Movies. To Find Out More visit www.TreatThePain.com

Just Published!!
by Rashani Rea & Kathy Douglas

Those who companion suffering daily, such as hospice nurses and volunteers, will surely appreciate this beautiful work. With 62 original art collages by Rashani Réa, five beautiful chapters by Kathy Douglas, and a foreword by Jean Watson, this exquisite book is a peaceful refuge for contemplation, inquiry, reflection and inspiration for those who traverse the joys and sorrows of nursing.

Kathy Douglas, RN, MPH-HA is a nationally recognized nurse leader, filmmaker and entrepreneur.

Rashani Réa is a prolific artist and musician, a creatrice of sanctuaries and a respected spiritual mentor.

“This is a beloved book and beyond a book. It is an evocative, poetic, ecstatic, and inspirited sacred, experiential calling. A calling to you--YES, YOU.”

— Jean Watson, PhD, RN, AHN-BC, FAAN, Living Legend (AAN)

“Those who companion suffering daily need to turn inward to metabolize what they have witnessed. This exquisite book, filled with beautiful images and poetic wise words, is the inspiration and support needed to grow a wise heart.”

— Frank Ostaseski, founder and director of the Metta Institute and author of The Five Invitations: Discovering What Death Can Teach Us About Living Fully

“In this unique time of the COVID-19 pandemic, this book should be considered a tribute to the tremendous courage being displayed by nurses around the world. There is much wisdom conveyed throughout by those who have been there serving others with such grace.”

— Greg Schneider President, HVA, co-author of The Changing Face of Hospice Volunteering in Hospice and Palliative Care

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LIFE BEFORE DEATH #11 -- Dependence vs Addiction

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