The "Opioid Epidemic" -- A Personal Take
I don't discuss this part of my life very often because one never knows who's reading and how they might take it. Guess something about the topic's nagging at me. I keep hearing more and more lately about the "opioid epidemic" and that old chestnut, the War on Drugs. It's certainly true that opioids and other pain medications can be a disastrous element in one's life if used incorrectly. Too often, articles about the epidemic and/or war fail to emphasize that: if used incorrectly. The fact is, they can save lives if used correctly, and I'm living proof of that.
I believe these articles are trying to more specifically reference the use of these drugs to create other, more dangerous substances, not that the ordinary prescription medications can't cause a train wreck. Addiction is a terrible thing, either way. However, for people who actually need these medications for chronic reasons, addiction is not typically a factor. That was something they told me early in pain management.
Addiction, as I learned, is not as much a concern in people who genuinely need the medication because they don't get the "high" from painkillers. It's just the relief. Peculiarity of the brain. Addiction, on the other hand, is a craving for and the use of more medication than is necessary or prescribed. There is a third element called dependency, which leads to withdrawal symptoms even in someone who takes only the correct dosage, but this doesn't mean you're an addict. It means you missed your medication, just as when you have reactions after missing your heart meds, your diabetes meds, your antidepressants, etc. Lots of meds cause dependency.
The reason I come out every so often when this topic heats up in the news is because I feel a certain personal obligation to defend the positives of pain medicine and the practice of pain management for the chronically ill (yes, a lot of us aren't dying). I'm 32 as I write this. When I was 17, I felt the first symptoms of what would eventually become a crippling pain syndrome for which there was almost no treatment and certainly no cure. At the time I became ill, symptoms like mine were related to another condition, but the reality - which would only become apparent years later - was that the organ thought to be the cause, wasn't. Pain in that region was merely a symptom of the larger issue. This realization even caused my condition to be renamed in medical literature.
I swore that I wouldn't see the end of my first year once the condition was in full gear, and I meant it, but I stuck it out because my mom begged me to. It was by sheer stroke of luck that I saw a physical therapist related to the university I go to, a specialist in the problematic area who was able to almost immediately recognize the actual problem. For the first time, someone actually knew exactly what I was feeling and exactly where it was! This physical therapist saw how serious my condition was and referred me to a pain management professor at the university. He, too, was pretty much immediately able to confirm the PT's diagnosis after his own exam.
The pain specialist was straight with me, which I think is important. He told me that my condition is rare, and clinically, there's little research interest in it. Certainly, it doesn't get a fraction of a fraction of the dollars cancer gets. As such, I was in this for the long haul, and possibly for the rest of my life. He couldn't fix me, but he could be the court of last resort and at least try to address my symptoms if I'd try to get over my preconceptions and trust him.
It took experimentation with different kinds of medication combinations for different kinds of pain -- neuropathic pain, muscular pain, etc. Eventually, we found what I felt was the best case scenario cocktail. It didn't come close to making me functional again (I'm still on disability to this day due to the syndrome), but pain medication mercifully took away that electrified knife's edge glancing along certain nerves and somewhat eased the muscles compressing them.
My pain management, and I think good pain management in general, goes beyond that. The program asks you to also see a psychiatrist, one of which they have on their team, because anxiety and depression are almost givens in people suffering from unceasing pain. That was something I avoided for a while because I feared being labeled nuts on top of addict, but it was a great help once I finally went. Relief from the anxiety helped me to better cope with my pain, to ride out the flares, and to clearly see that my worst pain days were not forever.
I've met a lot of people in the same situation, even people my own age over the years. There's this odd perception that young people can't be chronically ill, but that's another topic. Anyway. So many of them have had experiences echoing my own, suffering for years before finally achieving a realization and getting their lives back through pain management. Is it a full life restoration? No, almost never. Sometimes, it's just a little bit, but that inch of relief pain medication might provide the chronically ill could do what it did for me: enable you to stick around and have a life rather than check out early.
Why write all this? Well, I've already explained how articles about the opioid epidemic and the war on drugs are often overly generalized to the point that they make pain meds seem evil in any circumstance and form. It can save people, and they're putting it wholesale to the pyre. Many -- including some doctors I've encountered -- feel they're only for pre- and post-surgery and people dying of cancer. Full stop. The rest of us need to find another answer. One doctor told me I should take up gardening. Yeah, if I could move. Oy.
Whenever these overly vague stories come out and these broad bureaucratic attacks are launched, doctors become frightened of prescribing medications they know are needed by their patients, and people are left suffering or worse. It's not that they don't want to help, but they also have to protect their own behinds when the heat has been turned up yet another notch. That one patient who turns out to have addiction issues out of countless successful patients can haunt a doctor's record and drive them out of the specialty.
That's a lot of rambling, but I feel passionately about the subject because of what pain management did to save my life. I'm still in a lot of pain every single day, but I haven't had to adjust my medications in many years, when we were still figuring out the proper combination. I never feel a want for the medication. If you do, then you have a problem to address, but it's usually not the case with chronic pain. It's just how the brain works. Most importantly, I haven't thought about suicide in a very, very long time.
Thanks to what the media and politicians have spread, I've known people too afraid to take pain medication even while in the hospital, including my mom when she recently broke her jaw! I resent the people who mishandle the medications, who push them on others, I pity the abusers, and despise those who cultivate these incidents for political points. It makes it harder for everyone, especially those in genuine need, to get care for a serious disease which may end up being artificially fatal as a result.
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That's the mentality behind this "war on opioids."
Even here on DU.
