Prednisone predilection to addiction and our bodies

Prednisone isn't "addictive" in the way other substances like narcotics are addictive. Prednisone replaces a hormone called cortisol which is produced naturally by our bodies. Cortisol is an important hormone and is vital to our survival. When we take prednisone, it is said that our bodies become "dependent" on prednisone but that isn't the same as being addicted to prednisone.

In my way of thinking -- there is a subtle difference between being addicted to a medication compared to being dependent on a medication. For all the bad side effects from taking prednisone -- I give it credit for preventing me from being addicted to pain killers like narcotics which I rarely took for anything.
https://health.clevelandclinic.org/addiction-vs-dependence
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When I was unable to taper off prednisone my body needed it and depended on me to take it because Prednisone suppressed my adrenal function so my adrenals didn't produce enough cortisol.

This wasn't the same as things like alcohol, tobacco, caffeine and narcotics when the body doesn't need these things for survival. However, there are documented cases where prednisone addiction happens but it is said to be extremely rare.

@dadcue so would taking a weeks worth kill my adrenals faster now? Making me need to taper again ?

@ronludington

I doubt it would "kill your adrenals."

Being "on and off Prednisone for 8 years and now on Kevzara and off of prednisone for 3 months" is a factor for your doctor to consider before prescribing the weekly dose pack. I suppose ...If you need the Prednisone dose pack you need it. Unfortunately, I think Prednisone is over-prescribed without much evidence that it actually helps anything. It is more like a band-aid that makes us feel better. For many common, self-limiting ailments, Prednisone use is a heavy-handed "band-aid".

This is only my opinion. I was on and off higher doses prednisone for a month at a time often during the 20 years before PMR was diagnosed. After PMR was diagnosed, I took Prednisone daily for another 12 years. I didn't kill my adrenals with prednisone but the endocrinologist I saw said that I had "resilient adrenals." There was a chance I would need Prednisone for the rest of my life but I haven't taken any Prednisone for 5 years since Actemra has worked for me. My adrenals weren't "permanently suppressed" but that does happen to some people. Prednisone tends to call to me and haunts me sometimes but I never want to take it ever again.

Even on a lower dose of prednisone is it not possible to prescribe a medrol dosepak? I'm remembering that in one of my rheumatologist letters to my pcp something to the effect of staying on a low dose and ordering a medrol dosepak for a cppd flare or another issue requiring a short term higher dose prednisone use.
'Predilection' is an interesting word, new to my vocabulary. I admittedly had to look up the definition.

Oh, when I was on 60mg, I loved it, no pain, felt like superman. I could do anything. But after tapering for 8 years, that love has changed to loathing for what I think it has done to me. But it still calls my name when I'm in pain. But I refuse to succumb. But your correct in my question, a meddrol pack could be prescribed for a number of reasons... I'm more familiar with the 60mg reducing to 10mg over 6 days... maybe that has adifferent name.

@ronludington
I can't imagine going from 60mg to 10mg in six days. In fact I can't imagine being on 60mg. My highest dose was 25mg and I felt great on that other than some minor shoulder pain.

@ronludington

It sounds like you were treated in the same way I was treated before PMR was diagnosed. I routinely took 60-100 mg of Prednisone and tapered off again in a month to treat flares of uveitis. It was prescribed to me that way by an ophthalmologist. I did those "Prednisone bursts" for uveitis more than 30 times during the 20 years before I was diagnosed with PMR.

Uveitis can cause permanent vision loss. I thought I would end up being blind several times. Fortunately my flares of uveitis would respond to a high dose of prednisone and I could taper off prednisone quickly again. One time I told my ophthalmologist that I was blind in my left eye and it was a "lost cause" to continue treatment. I then proceeded to tell my ophthalmologist that I "didn't care if I ended up being blind" in one eye because I felt great on 100 mg of Prednisone.

I didn't go blind and I tapered off 100 mg of Prednisone but it took me 2 months to taper off instead of 1 month. My ophthalmologist said he didn't want me to feel too good about being blind so he wanted me to taper off Prednisone as fast as I could.
https://www.mayoclinic.org/diseases-conditions/uveitis/symptoms-causes/syc-20378734
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After the above incident , I learned that one of the side effects from high doses of prednisone is euphoria --- a false sense of well being. There are many things they fail to mention about high dose Prednisone and/or long term Prednisone use.
https://www.uspharmacist.com/article/systemic-corticosteroidassociated-psychiatric-adverse-effects
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After PMR was diagnosed, my rheumatologist said I would need to take Prednisone "long term." She didn't realize I would need 12 years of daily Prednisone to treat PMR. I finally tapered off Prednisone after Actemra was started. First, I had to overcome Prednisone induced adrenal insufficiency from long term prednisone use.

I have been Prednisone free for 5 years and my pain is reasonably well controlled.. I probably still have some side effects from long term Prednisone use. Some side effects don't go away as soon as Prednisone is stopped.

Now I need to figure out how I will get off Actemra. Fortunately, I don't have any severe side effects from Actemra like I had during 12 years of Prednisone. My rheumatologist says there is no compelling reason for me to discontinue Actemra.

Prednisone didn’t do much for any of my arthritic joints but I read they are prescribing it for rheumatoid arthritis.

@caroljeand

The history of prednisone dates back to when it was first used to treat rheumatoid arthritis. There was a lot of fanfare until all the side effects happened.

From artificial intelligence:
Key Milestones in the History of Corticosteroids
• 1948: Rheumatologist Philip Hench and his team at the Mayo Clinic first used cortisone (then called Compound E) to treat a rheumatoid arthritis patient, providing dramatic relief and earning a 1950 Nobel Prize.
• 1950: Arthur Nobile first isolated and identified the structure of prednisone by using bacteria (Corynebacterium simplex) to oxidize cortisone.
• 1955: The Schering Corporation successfully created a commercially feasible synthesis of prednisone (marketed as Meticorten), offering stronger anti-inflammatory effects with fewer fluid-retaining side effects than original cortisone.
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The following link is a good historical account of Prednisone including when the side effects were first coming to light. Don't believe for a second that Prednisone side effects are "easy to manage when you know how."
https://steroidsandme.com/articles/a-brief-history-of-steroids

@dadcue
Anyone see this old movie? I remember seeing it decades ago way before I was old or had PMR.
“ The definitive Hollywood film about a patient taking a "miracle" corticosteroid is the 1956 psychological drama “Bigger Than Life” staring James Mason!