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Previously Published in Practice of Madness Magazine, “Undermedication Hurts: Patients Invisible Casualties of the War on Drugs”
Sometime after OxyContin hit the market, in certain areas it almost entirely wiped out the market for heroin. OxyContin, or oxycodone, the opioid component of this most effective painkiller ever created, in Percoset, Percodan, and other pills that drastically improved the lives of people living in pain. If you have never been in constant, unrelenting pain – either because of a chronic illnesses like cancer, or a traumatic injury/injuries such as a serious car accident or physical assault, or a painful condition that “doctors are just beginning to understand”, like fibromyalgia, neuropathy, an autoimmune disorder not otherwise classified (like Lyme Disease) – you cannot fathom it.
No, it’s nothing like the worst migraine you ever had. Migraine headaches are awful, but have a beginning and end.
No, it is nothing like when you got your wisdom teeth removed. Or developed a dry socket. Not even that root canal, though it was, admittedly, a bitch, it was in many ways the opposite from chronic pain. When there is no end in sight, pain takes on a much more frightening character. Time shrinks and expands at once.
Chronic pain is quiet, and so are most people who are in chronic pain. Try to imagine that migraine, but located in your mid back and radiating up your neck, down to your lower back and abdomen, and mixing things up with knives to the back and cramps that cover half of your body, burning, and soreness to touch, never mind the aftermath of movement. I know, you cannot, really, and that’s not your fault. I had no idea either, and was quite happy that way.
Chronic pain is quiet because people who are in chronic pain make terrible self-advocates. Not only are you physically crippled, which impairs mental functioning – I have trouble speaking in sentences sometimes – but you walk into any doctors’ office, any specialist, even the guy that is supposed to be responsible for “pain management” knowing that your every move and every word are being judged, because you are guilty until proven innocent. You are guilty of being a drug addict.
You are screwed. Evidently, many of the people that starting obtaining oxycodone for “recreation” were among my same age and gender demographics, and had similar body types (I was taunted for being skinny from age eleven and still am to this day) – you know the story, <em> “it all started with one prescription before you started getting them off the street, spending hours and days at emergency rooms and doctors’ offices feigning pain”</em> , a story that one blows my mind, because I never want to see the inside of another ER or medical office again, so if I am present, which I despise, it is not for a quick buzz. The story is over, though, as Miss “Victim” of “One Prescription” could not afford a $300/day pill habit forever, and then heroin returned, since it was far cheaper (single pills go for $30), and provided drug addicts a time-trusted, and, evidently, best option for those seeking an opiate high.
Heroin is actually a very poor painkiller. It gets you high. I am not interested in a high, and would really like to know what on Earth the fact that some people spend their weekends crushing up the pills that save me from being tortured from my own body and inhaling them or smoking them or whatever, should have any affect on how I – someone that spends weekends working, writing, reading, and once in a blue moon watching a movie or going out to eat – am treated by physicians.
It seems quite predictable, not at all surprising or shocking, that when the most effective painkiller to be discovered to date was released, some (young, thin) people that take pain medicine for kicks, found out about the new slightly different version of the same buzz or faster version of the same buzz or longer version of the same buzz – it being an opiate, like heroin and opium are – and started trying to acquire the new painkiller to mix the “fun” up a bit and catch the latest buzz. As a chronic pain patient that only takes such medicine to get the machete out of my mid-back for a few hours or alleviate the aching after the spasms are over, so severe I sweat and struggle to catch my breath. Instead of getting addicted to one high, some fell into OxyContin/oxycodone addiction. And who really cares, because they rediscovered heroin and lived happily ever after.
Yes, I am being ironic about the “lived happily” part. I know that most long-term addicts are not happy people and the fun stopped for them long ago. My problem and what is becoming a problem for most chronic pain sufferers in Washington state and several others, however, is pain. Not addiction. Physical pain due to severe injuries and illnesses, and addiction, are most often completely mutually exclusive of one another.
So why are most doctors refusing to write anyone a prescription for pain medicine, regardless of whether they have cancer, or survived a horrific motor vehicle accident (and lived to feel the pain), or have no documented reason to be in pain but a bunch of slightly different stories and do not appear to be in pain like the other two do? All three hypothetical young women are requesting the same painkiller – cancer patient, trauma survivor, and someone who mixes up the particulars but insists she needs it. Is it really that difficult, doc, to ascertain who is sincerely in the throes of life-sucking pain, and who woke up and felt like going to the doctor instead of the dealer?
There has to be a reason why most doctors have suddenly lost their ability to assess pain, not only as a clinician, but as a person with any common sense.
After asking through sobs what the reason is for their seeming inability to empathize with other human beings, doctors have enlightened me.
It’s the DEA (the United States Drug Enforcement Agency – the federal police given the task of waging war on illegal drugs)! Purportedly, DEA agents are “after doctors’ licenses”, over and above the fact that, in this particular time and place, doctors are trained to reflexively assume patients will almost always snort the pills or sell the pills or swallow pill bottles whole. Even though statistics reveal that almost all patients swallow one or two tablets as needed for pain, as is instructed on the prescription bottle. Or at least when painkillers were still being used, they were distributed in bottles labeled with such instructions.
When I am given medicine, the idea of making it into some kind of powder and inhaling it, amazingly, does not cross my mind.
I pay a lot for insurance, and selling some painkillers would not put a dent in my monthly premium.
I guess the DEA and others in power are concerned that insurance fraud, public and private, is going on?
Selling my pills does not cross my mind because I need those pills. They are the difference between living my life or enduring constant suffering while I wish I could just live my life.
Doctors also warn, “Those pills are dangerous!”
The acetaminophen (Tylenol) in Percoset would do permanent damage to my liver before I ever “overdosed” on oxycodone. Percoset are mostly Tylenol, and Tylenol is the cause of 65% of liver-related ER admissions. I happen to know this because of research on acetaminophen/paracetamol when I worked as a medical writer. No one ever tells you this. Tylenol is far more dangerous than oxycodone! Look it up!
And if I was depressed?? I would not care to seek treatment, because I would have no desire to function. Trust me, I’ve been there – which of course increases your suspiciousness, though, mind-blowingly, the third of Americans that suffer from depression sometimes also get cancer or are hit by cars. The statistics of the two coinciding are not more or less than the occurrence of not having a history of depression and getting cancer or being hit by a car. I have been suicidally depressed, but, as the Universe laughs, that was resolved long ago, and I am now happy, and my personal goals and dreams are on my doorstep.
If only I could get to the door before they left.
“She’s probably on drugs.”
The thing is, I envision my fiancé leaving me, and see the book deal walking away because I cannot type for long enough to produce material, and I see the evaporation of my life just as it started to happen. I imagine becoming dependent on the same government that the DEA works for because I cannot be a productive citizen of society, or my household, or a workforce. Not when it hurts to be awake, no one wants to be near me, I cannot take care of myself, and I have no other choice. I hate this so-called “life”.
I hate being a victim of the system, yet again.
I hate the doctors’ appointments determining my schedule.
I hate being treated like a criminal because chronic pain patients are the new black.
I hate being.
Being forced to live like this because a doctor who has never physically examined you, seen your medical records, or your MRI, is paranoid about the DEA, and cares a hell a lot more about his license than the Hippocratic Oath or reading over your file or listening to you speak.
I eventually reach for the last option. After taking Neurontin (gabapentin, similar to Lyrica) for two years, I feel like it damages my nerves when I take it. My joints swell. But, I will feel a little “off”, and the pain feels different. My physiatrist’s office keeps telling me that my Primary Care Physician will surely take care of getting me a handful of Percoset – even they do not realize that he cares about his medical license, not about my pain. They have not had to go through this, and I hope they never will.
But I’m paralyzed, because doctors are no longer treating pain. Washington State has been one of the hardest places hit by strict regulations about pain medicine,Jennifer L. Reimer
My doctor will not even return my calls. I lie in bed for hours, sobbing. I am scared of the pain and even more scared of it taking over my life, that it already has, that the people closest to me think of me differently. I cry because I want to get out of bed. I want to do laundry and dishes, I want to cuddle with my fiancé, I want to read and write, I want to return emails, I want to make money, I want to make a meal, I want to make a garden.
But I’m paralyzed, because doctors are no longer treating pain. Washington State has been one of the hardest places hit by strict regulations about pain medicine, that even pharmacies must abide by. Strangely, things changed even more, increasing the number of patients like me who cannot function because their doctors also chose to stop prescribing medicine that can help us to function, since January 1st, 2014. The day the ACA became effective. I pharmacist I spoke with thinks that there is likely a connection, but neither or use could imagine what it might be, and she looked quite afraid. And she felt sorry for me.
The intake staff at hospitals, pharmacists, paramedics, and children that look at me when I am in pain – they can tell I am suffering. But only a medical doctor is allowed to help me, and I do not know of any medical doctors, here in Seattle, that prescribe pain medication to chronic pain patients. Evidently, their licenses are more important to them than treating patients. Amidst all of the noise about OxyContin abuse and “overmedication”, a new epidemic is spreading - under medication. It is not yet known to be lethal, but it will make you wish it was.
Lucky me, maybe one day I’ll be pain-free and functional and sue. Maybe one day I’ll get up in the morning and not be afraid of the pain, that only I can feel. I know this is hard on everyone around me, but I cant help but think, “at least you do not have to live inside my body!” Maybe one day doctors will start writing prescriptions for chronic pain patients again – the people who need these medicines, and right now, are enduring cruel and unusual punishment at the hands of some combination of changes in the “healthcare system”, the specters of people who abuse the system full-time, the DEA, and medical doctors.
Maybe one day you’ll be a lot more worried about your medical license because you caused me needless pain and suffering, because of discrimination and selfishness. It seems rather odd to have a license to practice medicine when you stop treating the sick human beings that you are supposed to help using everything available to you, including your prescription pad. To treat people in pain like criminals for being in pain? Now that sounds like a crime.