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I suffer from chronic pain.

It’s important for you to know this so you have context for my current leery attitude towards the vehement, almost-religious hysteria about our current “opioid epidemic”.  In 2000, I blew out a disk in my neck, which bulged into my spinal cord, causing some pretty excruciating pain.  This was only allieved by removing the offending disk, taking a chunk out of my hip (which hurt every bit as much as it sounds like it would), filing it down, putting it in place of the disk, and clamping it all together with a titanium plate so it can “fuse”.

Like most surgical procedures, this had some unintended consequences, like lack of mobility in my neck, and a moratorium on any “violent” activities that might hurt the neck.  (Which basically amounts to anything more “violent” than “walking”.  Even swimming is out.  No biking. Or racquetball. Or skiing.  Or soccer.  Or running.  Or disk golf.  Or regular golf.  Or bowling.  Or…well, you get the picture.). But the worst of which is I have pain at the base of my skull on the right-hand side all the time

To a non-chronic-pain sufferer, it’s almost impossible to get this point across.  I hurt all the time.  There are no times when I don’t hurt.  Some days I’m lucky and it doesn’t hurt much, but it never doesn’t hurt.  If I try to turn my head all the way around, it not only hurts, I get faint.  This is my cross to bear, and it sucks.  I don’t like to talk about it because for one, who wants to hear someone whine about their pain, but for another I mostly control it with meds.  Including opioids.  I take two: Tramadol (which is partially an opioid) and time-release morphine (which is the full, extra-strength, no-kidding king o’ opioids).  I’m not happy about this, and I’m especially displeased by some of the side-effects, but I’d much rather deal with a bit of constipation than constant, mind-numbing pain.

It’s important you understand just how severe this pain can be before I get on to the supposed “epidemic”, so please forgive the following bluntness.

Take a butter-knife, a dull one, and press it to the soft part of your head just under the base of your skull.  Gently.  Maybe with, oh, 5 pounds of force.  Annoying, but not debilitating.  Certainly you’ll notice it almost all the time, but it won’t keep you from doing daily activities.  (Unless you turn your head past 75 degrees or so, at which press down harder on the knife, and twist.)

That’s the case on my meds.  With the opioids.

Remove the meds.  What’s the pain like?  Remove the knife and replace it with a drill press, which punches in through your skin and all the way down into your spinal column with 50, 60, 100 pounds of force.  Over and over and over again.  If lucky, it’s synchronized to your heartbeat, so you can at least anticipate the pain.  If you’re unlucky, it ebbs and flows and thrusts to its own internal, unpredictable rhythm, causing the pain to intensify or decrease with no warning.  The pain is so intense it creates “referred pain” in other parts of your body; in my case the shoulder.  It also often triggers my migraines.  I “only” suffer from “common” migraines, the least painful.  Combine these migraines with the neck pain, and it’s . . . 

Let me put it this way:  The last time my pain peaked (I call them “pain flare-ups”), I was in the shower at 3am, in the dark, crouched on the floor with the water pounding down, weeping and wondering if I shouldn’t just kill myself to end the suffering.  If you know me, I’m a basically positive person.  It’s hard to get me down, and harder to keep me down.  

That’s pain: Weeping and suicidal in the shower on the floor in the dark, because you can’t stand it.  Cursing an unfeeling God for bringing this upon you.  I honestly don’t know how people who suffer worse than me—and there are many!—don’t become atheists.  Or simply kill thesmelves.

Which brings us to “the opioid epidemic”.  There’s been a number of articles in various papers and magazines talking about the “scary increase” in opioid addiction and overdose numbers. (Look at this one, or this one, or this one; and that’s just for starters.)  More people dying or ODing from prescription opiates, and what to do about it.  And the alarmist language is impossible to miss, with the proposed solutions almost always being more draconian restrictions.  (Honestly it reminds me of the Reagan era “war on drugs”.)

Let me say a few things about this.  

First, I don’t know how many of these “overdoses” are from people just like me who decide they’ve dealt with it long-fucking-enough and the time has come to give the karmaic wheel a turn.  In other words, how many of these alleged “overdoses” are actually suicides? Has any effort been made to find out?  Because if it’s a significant percentage (as I suspect), it’s not an “opioid epidemic” so much as a “chronic pain and suicide” epidemic.  And creating more restrictive and draconian laws to restrain opioid prescriptions won’t help.

I also wonder how many of these supposed overdoses, or the people who go to multiple doctors to get extra doses of opioids, are simply suffering severe pain

Now don’t get me wrong: I know there are people who use the medical industry and the holes therein to get drugs to sell to other people for profit.  No question.  Not arguing.  Not do I argue that people don’t get addicted.  

But what percentage of the “getting more than they should” are actually criminals, and which are simply desperately in-pain people looking for help?  What people are actually not addicted to opioids, but addicted to not being in pain all the damn time?

The reason I think these distinctions are absolutely critical is because in the current (and coming escalating) war against “opioid abuse”, people like me are going to be collateral damage.  A quick story to illustrate what I mean.

When my doctor prescribed morphine for me—which I objected to, but he insisted was the next step—I had to sign a multi-page waver agreeing I would never take any more than he prescribed, that I understood he would drop me like a hot rock if he discovered I was getting meds anywhere else, that I had to submit to random urine tests, and that he could have my first-born for all I know.  It was unbelievable, and I don’t think my continued use of the word “draconian” is over-blown.

Then I had the aforementioned flare-up and suicidal contemplations, during which I took the other meds (Tramadol, Exedrin) I was “allowed” to at my discretion, but out of desperation took one—ONE—extra morphine tablet.  When I told my doctor at the next visit, I was punished.  And there’s really no other word for it.  I was lectured.  I was told I needed to call in first.  (At 3am from the floor of the dark shower?)  I was told I would need to come in every two weeks rather than every four for the next six weeks, at any visit of which I was going to have to have urine samples.  I was threatened with dismissal as a patient if I ever did it again.

ONE EXTRA TABLET.

Even at the time, my doctor admitted I was a “model patient,” that I had always done as they asked, gotten blood work when they asked, always been straight with them.  And now a “model patient” was being punished for, in his agony and desperation, taking a single extra tablet.

I think about this every time I read a call-to-arms for making our laws even more draconian than they already are.  And I think about the fact that these more draconian laws will inevitably hurt the people most who are following the rules.  If I, a model patient, have to go in every four weeks for a “med check” visit, am subjected to random urine tests, and treated like a criminal when I take a single extra morphine tablet, how much worse are they going to make it for me and the other, non-model patients?

So please, do me a favor when reading about this “opioid epidemic”:  Bear in mind people may be overdosing not because they’re drug addicts, but because they’re in such massive pain they’ve become utterly desperate.  And remember what one “model patient” has to go through and think how much harder it will be.  

And have sympathy for us chronic pain sufferers.  Because sometimes, I’m telling you: Opioids are all we’ve got.

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