So painkillers are making news. The New York Times is reporting that more women—and in particular older white women—now die of painkiller ODs than from cervical cancer or homicide. The Los Angeles Times, meanwhile, has a story about how the Centers for Disease Control and Prevention is criticizing doctors for prescribing painkillers at such high rates.
It’s excellent, of course, that opiate dangers are being exposed but for those of us who are around addicts with any sort of regularity, news of this sort is hardly surprising. And while I applaud the CDC for trying to crack down, I wonder how much can be done without educating the medical community more about addiction.
I recently had a bout with chronic pain. And when I say “bout,” what I mean is that from pretty much the beginning of December last year through May of this year, I was in such severe pain that I couldn’t walk. I spent entire days in bed, gulping down Advil so that I could hobble to the bathroom. Forget showering or eating—I couldn’t stand so I couldn’t prepare food and I couldn’t sit so I couldn’t eat it; I lost 15 pounds and was too miserable to even relish in that. I couldn’t do much of anything, really, except slouch in a certain position on the couch. Sleeping became a rarity.
It was, I was told, sciatica. An MRI showed a bulging disc and a disintegrated disc in my back, but for some reason no one could explain the pain radiated down to the side of my left knee, where it lodged itself and started screaming. It felt, as I often told people who usually nodded uncomfortably before looking for an excuse to change the subject, like a serrated knife was digging into the side of my leg. One of the orthopedics I saw told me that I also had an extruded vertebrae. I didn’t know what that was but it sounded painful. I went to chiropractors, physical therapists, healers and even Marma specialists (it’s an ancient Indian acu-point pressure treatment—don’t ask). I changed my diet entirely, cutting out coffee, bread and really everything besides celery, cucumbers, tea, honey and butter, because one of the Marma specialists told me it was all the gluten in my diet that had caused the problem and that if I just ate what he told me to I would be fine.
I was not fine. If my pain was minimal enough for me to be able to sleep, I’d wake up and have a few seconds of hope as I imagined stepping out of bed without pain. And then I’d try it and feel the searing edge of the serrated knife. I tried working steps on it, surrendering to the pain, talking to the pain, writing to the pain, doing deeper emotional work than I ever had before because various and sundry people I knew told me that the pain was childhood trauma I’d never dealt with (I live in LA, where suggestions of this sort will happen more than in other places). Nothing worked—not steroids, not Cortisone shots, not this machine with suction cups that stimulated nerves that I stuck to my leg and turned up so high that I burned through two of the machines. Finally, after months without relief, my sponsor and I worked through every aspect of the possibility of me taking painkillers before I went back to my doctor and requested some. (I never actually spoke to him, just to his assistant.) And the assistant cheerfully prescribed me Tylenol with codeine. A million prayers proceeded my swallowing of that drug. And that was followed by…
Nothing. No relief whatsoever. I wasn’t high, either.
I called the doctor back the next day, explaining to his assistant that I needed something stronger. He prescribed a drug called Tramadol, a non-narcotic pain reliever.
Again, no relief.
So I called back the next day and this time, the doctor’s assistant’s tone had changed. “We’re cutting you off,” he said. “We can’t help you anymore.”
“Can’t help me anymore?”
“We can refer you to a pain management clinic.” I could hear the judgment in his voice and realized that it was the fact that I’d told him, during my first visit, that I was an addict and couldn’t take anything that would threaten my sobriety, which was causing it. As soon as we put her on something, she just wants something stronger—that’s an addict for you, I could practically hear the assistant thinking. My insurance didn’t cover the pain management clinic he referred me to and so I ended up cross-referencing my insurance information with pain management clinics and finding only one possibility—a shady-looking and sounding clinic in West LA. What ended up happening at that point needs to be saved for another time but my point now is this: when I was wholly honest about my sobriety and in unbearable pain, I couldn’t actually get any relief—or even on the phone with the doctor to explain myself. In other words, because of the fact that I’d told the truth, I’d been characterized as a scheming addict. And does that actually help matters—meaning, would that stop an addict trying to get Oxy’s? Because if there’s one thing I know about addicts, it’s that someone saying no isn’t going to stop them; it’s just going to make them go somewhere else.
I certainly don’t have the perfect answers on how to handle our opiate over-prescription problem. But I think that cracking down without having far more open communication about addiction leaves determined addicts no better off than they were before and people in genuine pain hobbling around.
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