Is insulin addictive?
I have been working this week on a blog about opioids and the Super Bowl ads for opioid-induced constipation (OIC). The blog has been submitted to CreakyJoints and perhaps in a few days it will be published. All of that is in the future of course.
Research
As part of my research (yes I do research things 🙂), I ran across several interesting discussions and questions about the addictive power of insulin. Such questions are being asked by people who do not use insulin but in some cases live with or interact with people who do use it. In some cases, the question is being posed by people who have been advised by their doctor to use insulin but who are afraid to do so because of the notion that insulin is addictive. This harkens back to the 1920’s (and other decades) when People with Diabetes were told once you begin using insulin you will never get off of the medicine (not true, type 2’s often come on and off insulin repeatedly depending on the circumstances). So to begin the discussion, let’s think about the word addiction.
According to Merriam-Webster, addiction is defined as:
A compulsive need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal; broadly: persistent compulsive use of a substance known by the user to be harmful.
By definition then if a person needs insulin it is not addictive. A writer to the online web site Medhelp is what got me thinking about the subject of addiction. The person who asked the question wrote:
“I have a friend of mine that has been a diabetic since he was 8 years old, he is now 48. My question to you is have you ever heard of anyone being addicted to insulin? It’s not the insulin itself but the effects of what your body goes through when your sugar is almost bottomed out.”
The questioner then goes on to say:
“I have seen him just take off and run full speed for maybe 75 yards, I have seen him pick up and throw things across the room that weigh as much as he does. After this rush wears off he will lay in the floor still not able to get up, but still will not drink any orange juice or nothing. “
and
“Basically he is intentionally dropping his sugar level for the effects of the adrenalin your body produces trying to recover itself.
If what is described is true, I suppose the person in question could be having an emotional issue that could be helped by therapy. In this case I have to doubt the account of the person asking the question. I do not doubt a person with diabetes might have several lows over the course of 3 years but the writer seems to think these lows are caused intentionally. I know for myself one low is one to many and no doubt the individual who asked the question mistook being low with something pleasurable. As anyone who takes insulin knows, it is not.
Responding to the question
I was so moved by the circumstances described that I made a response to the person who asked the question. If my response is posted, you will find I suggest three things:
1. Insulin is not a pleasurable drug to take. Sometimes it hurts going in and it produces no response that is pleasurable other than not feeling really bad if you need it,
2. People with diabetes do sometimes require emotional support, I required therapy to come to grips with my diabetes, the friend being described might need a gentle suggestion that therapy is in order, and
3. There is no pleasure in going low as a result of taking too much insulin. Anyone who takes it will tell you that shaking, sweating, and sometimes becoming unconscious is not at all pleasurable.
Diabulimia
Of course this writer is not alone in questioning the addictive powers of insulin. In fact, if you look up insulin addiction you get a rather large listing of articles some of which deal with body building, some deal with using insulin to eat more carbohydrates but most deal with a very serious and real issue of diabulimia. So that spun me in a different direction and I hope you will keep reading, I learned a lot as I conducted my research.
According to DiabetesHealth:
“Diabulimia is an eating disorder in which people with type 1 diabetes deliberately give themselves less insulin than they need for the purpose of weight loss.
There are no agreed upon estimates of the number of people with type 1 diabetes who suffer from diabulimia. But it might be a particularly large number in the 13 to 35 age group of people with type 1 diabetes or who are prescribed insulin. You can read a lot more about this in a terrific article “Disordered Eating Behavior in Individuals with Diabetes: Importance of context, evaluation, and classification” (Young-Hyman and Davis, Diabetes Care 3/2010). If you do not know much about this issue I suggest starting here or with a terrific article “Diabulimia: What It Is and How To Treat It” (Huifeng-Shih, Diabetes Health) or a more recent article in Diabetes Forecast “Hope in the World of Eating Disorders and Diabetes” (Neithercott, 3/2013) I found all three to be worthy reads.
So the basic question: is insulin addictive? It is not likely that insulin is addictive. Depriving a body of insulin to shape it, is definitely a serious problem and yes commentators who know the subject very well suggest that diabulimia is an addiction. However giving an improper amount of insulin (too much) or (too little) knowingly, probably signals the need for support (emotional or educational). Oh and just for the record, no matter if you are a 1 week or a 42 year or more type 1 we all can all use a little support. So let’s not judge, instead let’s offer help and resources.
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rick
Take away for March 15, 2016
• Insulin itself is not addictive.
• Diabulimia is the act of withholding needed insulin to manipulate weight.
• Diabulimia is a very serious problem
• If you look up Insulin addiction, get ready to spend an afternoon of reading
Thanks for trying to set the record straight! (I never imagined that anyone would ever come up w/ this idea that insulin’s addictive – blew my mind.)
Yes it is pretty incredible that someone would think this. But I guess if one were uninformed that might believe it. Still it seems an odd thought for those of us who use insulin.
Addiction seems very absurd to people who are rational but addicts are not rational thinkers. Addicts get addicted to all sorts of things that are not-pleasure inducing. Some people cut themselves repeatedly with razor blades, etc. because of deep emotional and physical trauma.
My mom’s addiction to insulin began shortly after she was diagnosed with diabetes. Something about her mental state at the time forbid her from admitting she was ill. She began lying to her doctor about her blood sugar readings and taking more insulin that was prescribed to make her A1C tests show she was managing her sugar well.
Was the A1C was now showing was how many lows she was having. She totaled her car because she was low when driving and then one month later totaled the 2nd car. After that she lost her license and began working with her doctor to get back on track. The doctor wrote her a lovely letter and she got her driver’s license back.
Since then the car accidents have only been minor ones, such as running into other cars in parking lots or driving over curbs and onto neighbor’s lawns. She has continued to lie to her doctor about these “lows” and even went as far as to fake the sugar readings in her journal which she would show her doctor at appointments.
After several years of finding her unconcious on the floor, naked, and having lost her bladder and bowels and laying in a pool of filth until someone comes along to revive her with some maple syrup my siblings and I decided we needed to talk to her doctor to see why her doctor was not helping.
After this things got worse. She stopped seeing her doctor althogether and now gets her insulin over the counter without a prescription from Walmart. She takes huge doses of insulin and eats lots of sweets (like jelly filled donuts) to keep her sugar from dropping too low.
After a nasty fall that left her with a busted shoulder, we found out how much insulin she was actually using. She was not able to do the injection herself so my neice helped her and my neice said she was told to fill the syringe as far as she could – beyond the last line and completly fill it. This is 10 times more than most people.
There’s no handbook on how to survive a loved one’s addiction. You start to see the person who raised you through a different lens. Their disease changes you. You spend most days confused, depressed, mad and burdened.
As her obsession with insulin worsened, I would only tell my friends pieces of what was going on just to get it off my chest. When she had a bad low, I would fly into a rage and scream and yell at her on the phone. Both us in tears as we hung up, and I was left feeling guilty and ashamed of my reactions but helpless and unable to make her see what her addiction was doing to me and the family.
Over the years, I tried to talk with her about her insulin over-use, but she never wanted to hear it. It forced me to come to terms with the fact I couldn’t change her and that it didn’t need to weigh me down. She refused to recognize she had a problem and actively denied it whenever anyone brought it up. I wanted to smash every vial of insulin in the house but she would just run up to Walmart and get her next fix. I finally realized that if she wasn’t willing to change then it couldn’t be my problem anymore.
We had always been very close. Her friends envied her close relationships with her children but now we rarely talk. And when we do it nearly always ends in an arguement. A few years ago she told me not to call anymore and suggest we only communicate via text message.
I have always wanted to help her, but I know I can’t. As long as she continues to deny she has a serious problem, I knew I am better off limiting myself to a few hours each year with her because it’s too frustrating and painful to be around her.
I saw her last on Christmas Eve. We had a nice day. As I left her home with my partner, she approached me for a hug. I felt my body stiffen a bit, barely embracing her. I patted her on the back, wished her a Merry Christmas and we left. Within the hour, I heard from my sister.
Mom was low, belligerent and fighting with the ambulance attendant.
so, I ask you… what else would call this if not addiction? Perhaps her addiction is to control. She may be trying to control the disease – I don’t know. I do not understand it. But she is addicted. And insulin is the drug that feeds her addition.
It is difficult to know exactly what to do. A doctor once gave me the best advice I ever received. It stuck with me and despite the fact, I ignored it at the time but it made a big difference to me. He said when you get tired of being sick and tired you will take care of your diabetes. In this case, It strikes me that your mom is not addicted to insulin. What she might suffer (I did) is an inability to accept diabetes. She may need to have therapy (I did). What I found was that depression was my main issue and once I got that under control, diabetes became much more manageable. In my case I wanted therapy I decided to go on my own and I knew I needed to go. There are other strategies to get your mom to therapy. For instance, you may locate a therapist and invite your mom into your sessions. That may overcome some of the stigmas associated with therapy.
I hope you and your mom will find a way through this. Insulin is a dangerous medication. It is difficult to use and yet as a person with diabetes, we do not have a choice. So the balance is always how to use it for to benefit and not harm ourselves and others. What I do know for certain is that insulin use should never come between a son and mother. I hope your situation will be resolved. we have a saying in the diabetes community, your diabetes may vary. What that means is that my experience will be different than any others in the community. So, of course, I do not know the answer to the complicated issue. But I do suggest that you and hopefully your mom will seek therapy as part of getting through this issue. In the hands of a trained therapist, I believe both of you can find a solution. Many blessings and good luck
Because I was having so much trouble posting my reply I feel I didn’t get to elaborate as much as I wanted since I had to type it three times, the other versions were much more explanatory as to what I witness daily. I am not thinking too clearly because I have barely slept because the ambulance was at my house again late last night. But I wanted to add that even if they aren’t addicted to the insulin itself some of them are addicted to the low (which I call his high) he only does this when someone is around to watch him. I can see why you would say no one likes to be low, I know I wouldn’t, but there are obviously diabetics that do this intentionally and are willing to lie or become violent to take that big of a shot knowing full well the consequences. There must be other issues going on of course in their brains. He is now 50 and has been a type one since the age of 9. “Normal people” learn from their mistakes “lows” Us care takers are not making this up. These are the extreme cases and cannot be compared to “normal diabetics”. He lies about the amounts of insulin he takes and sometimes lies that he didn’t take a shot at all. Like the first person mentioned, he fills up the entire syringe. He refuses to use his pump because the doctor can manipulate it. He still found ways to get low with the pump too. He would just refuse to eat. He also lies about the reading itself so I have to check the monitor. Instead of trying to explain these extreme cases away because they are so rare it would be nice for someone to look into this further. We obviously aren’t the only ones. This has now ended a marriage.
I am sorry you are having such difficulty. I suggest you might reach out to one of the many online groups for diabetes. Almost all of them welcome caregivers as well as PWD’s. I use http://www.TUDiabetes.org and I know you woudl be welcome there, if you wish to join us.
Todd –
Your description of our mother’s addition is an exact sequence I am presently witnessing – every detail – the rush, the runs to Walmart for vials. the adrenaline rushes. Worse even, my mother is a former nurse with knowledge fo the insurance system. We have found her recently nude on the floor semi-conscience. She also had highs which would make her rush herself to the point she fell and broke her shoulder as you described. She is well on her way to killing herself with it. I wanted you to know you are not alone and I question the medical field, insurance companies and Walmarts willingness to sell this drug like candy. I would love to compare notes sometime and thank you for sharing.
Thomas, I do not know if you use TUDiabetes.org, but you would be welcome on that site to ask for advice or commiserate with those of us who have diabetes. I hope you make it over to cool site.
rick
Rick –
Thank you and I will look it up. Even though I am not a diabetic, I am curious about the misuse of insulin and the players like Walmart who profit on it’s lack of control. The comment I responded too was a description I could have wrote myself of the current state of my mother. By the way, she was an exceptional nurse and a specialist in the insurance industry – a perfect combination for abuse if irresponsible. I know my mother’s abuse is her own responsibility but I am also equally surprised by the protection of insulin as a commodity and the disregard of
addiction in general. Insulin is a catalyst not the true source of the addiction, but the abuse of it, as my mother has secretly shown, will be the end of her. She is well on her way and asking me to go to Walmart incessantly even though she is in a controlled PT environment.
First I apologize for not approving your comment earlier, I thought I had and when I logged in today to do some maintenance I noticed i had not. My apologies. We as humans are programmed that anything good is means more can be better. I hope your mother is well.