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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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