Stopping Painkillers From Killing

painkiller.afterpartyychat

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.

the talk.afterpartychatAnna David is the New York Times-bestselling author of the novels Party Girl and Bought and the non-fiction books Reality Matters, Falling For Me and By Some Miracle I Made It Out of There. She speaks at colleges and on TV about addiction and recovery. Image courtesy of pillarcommunity.



Categories: Culture & Politics

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7 replies

  1. This is very good article. The author is concise and relevant. There is an ever growing need to bring issues like these to our attention.

  2. That’s an amazing story, Anna. I hope you’re feeling better now. For a long time doctors were criticized for prescribing medications too easily, but now it seems like they’re going too far the other way. I had an incident about 3 years ago. I was in the shower on a Sunday morning, and I must have twisted too far the wrong way. I felt a SNAP in my lower back. It wasn’t painful, but it was something I hadn’t felt before. Slowly over the next several hours I started to feel a lot of pain in that area. By mid-afternoon, I was lying on the floor on my back in my living room with my legs up on a chair. It was the only position where I could find some relief. There I stayed for almost 2 days without being able to sleep. I could get up for a few minutes at a time before the pain started getting bad again. My left thigh was constantly in spasm and there was some numbness in my left leg. Finally on Tuesday morning I decided to go to the emergency room. I called first to see if there was a long wait. Thankfully there wasn’t. The doctor saw me within minutes of my walking in the door. He checked me over, even having me sit on a table so he could hit my knees with his little hammer. My right leg was normal, but my left leg didn’t react at all. He did it over and over, telling me to look up or close my eyes so I couldn’t see when he was hitting me. No reaction. He finally gave me prescriptions for 3 medications including a pain reliever and an anti-inflammatory. Those medications lasted 3 days. I had to make a chart because one medication was taken every 4 hours, another every 8 hours and one 4 times a day. Thankfully the medications helped. After they ran out, I took lots of Tylenol and Advil for another month. I finally started feeling normal again. My experience was obviously very minor compared to yours, but it still helped me realize how debilitating back pain can be, as I’m sure migraines and many other health issues are.

  3. Great article. I just went through this whole process and DID NOT tell the doctor I was an addict in recovery. I had knee replacement surgery and was in intense pain. I got the proper medication to get me through the initial 6 weeks. With the on going coaching of my sponsor -I told the doctor that I needed to come off the narcotic pain killers. I too was recommended Tramadol. It has done absolutely nothing and I am now fighting the pain. Had I not had a plan going into this operation with my sponsor to let him know what is going on with my meds – I would have been able to continue on the oxy’s and percs and would have been in grave danger.

  4. Wow – I hope you’re not still feeling that kind of pain. I’m not an addict but your story brought back painful memories of my bout with cancer treatments (6 weeks of radiation in my head/neck area) a few years ago. I couldn’t eat (lost 50 pounds) and couldn’t sleep for months. I was seeing a psychiatrist that was giving me meds for anxiety and depression (related to the cancer treatments) and they weren’t helping at all. When he wouldn’t increase the dosage or give me a different medication – he said he was already giving me the strongest meds/dosage he had ever prescribed – I tried finding a different psychiatrist that would try something else, but had no luck with that. I remember worrying about becoming addicted to the Xanax and other meds while I was taking them but my body finally started healing from the radiation and I was able to wean myself off them.

    I agree with the points you make about the medical community seemingly being clueless about addiction and that you shouldn’t be “punished” for telling the truth about being an addict. I have much admiration for what you’ve been through, where you’re at, and what you’re doing to help others, Anna.

  5. Very thoughtful piece. The problem comes when governments, doctors or any one in authority start bureaucratising things that should remain in the realm of common-sense.

  6. Hey Anna My name is james. I’m an alcoholic addict. I also have to deal with a degenerative, genetic disease. I have papers stacked close to a foot high codifying every symptom and I currently deal with; along with things to come. It ain’t pretty. I’m classified as terminal.
    It has taken a turn for the worse over the last couple of months. Who knows, this might be the time they get it right! Hahahaha… Why am I laughing, Just kinda twisted sense of humor, After 18 years in the program clean and sober; and yes I claim every damn day! This has gotten worse and worse.I’ve gone from minor “lumpectomies (non-cancerous) To organ removal and replacemnt.
    I’ve done this with the the aid of pain killers.. I claim my time in the program even though I have been taking pain killers because I stuck with program. I had to work the 12 steps. The I had to learn how to aapply them to my life. Now I live them. Including going to meetings when possible, working with others when asked and answering my phone at all times.
    During this time I’ve run across a whooooooole lot of people who say you are not clean and sober! “Bet me A** Hole!!!”. I have stopped argueing with them and just hand them the big book and ask them to show me where in the book it says I can’t be clean and sober while takeing prescribed medication. The key here is prescribed medication. I won’t tell you I haven’t thought about taking them and just seeing. LOL… But that is a thought; Not an action. Phew…Sobriety safe. I have gone to some serious lengths when I thought I was skating that edge.
    So yeah I think there is a problem out there, but, as long as you stay in the rooms, and stick with the program and work with your sponsor and do all the other things we are supposed to do when working a healthy program their is no problem. With God and AA I have managed to put tpogether 18 years of clean time I am proud of.

  7. Being honest with doctors about a history of substance use (alcohol and marijuana, self-medicating for a mood disorder, which ended with the right prescription medications) was a huge mistake. Plus, since I already take two controlled meds, no one under the sun will prescribe painkillers that do anything – never mind that I can’t take NSAIDs and Tylenol might as well be candy. My NP suggested instead that I look into acupuncture, which is a nice idea, but somehow I doubt that’s the answer for severe menstrual cramps.

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