Tuesday, October 30, 2018

Chronic Pain & The Opioid Crisis


I just found out I was one of “those people.” You might know one of them. Those people with chronic pain. People who may have fallen into opioid addiction because of that chronic pain.

I never thought that I was someone that had chronic pain until listening to my friend Karen Litzy’s podcast on the subject. Let me back up. From the time I was a teenager until about the time I turned 45, I had migraines.

Throbbing, unremitting migraines. Keep you up all night migraines. When I ask patients what their pain level is on a scale of 0 to 10, I sometimes think about those nights when I was a 10 out of 10.

I tried everything to try and control my headaches. Nothing much worked. I saw a neurologist. I had all kinds of tests. I tried a lot of different treatments. Nothing. I had no choice but to keep going. I had responsibilities. I finally found a formula that seemed to keep my headaches somewhat manageable—hot showers and lots of Excedrin.

Most of my headaches arrived in the middle of the night. My routine was to eat something (with all the Excedrin I was taking, my stomach was always irritated), take two Excedrin, and jump in the shower, turning the water on as hot as I could stand. There were many nights when my wife would hear me in the shower at maybe 2 AM. There were lots of nights when I would empty the hot water heater. The hot shower was my best relief. After the shower I would take two more and try to go back to sleep.

Through the years, I tried all kinds of medications. One seemed to work but then I discovered it was based on a barbiturate and so I quit taking it. Excedrin became my drug of choice. I always had several Excedrin in the pocket of my pants. Always. When I was having the worst of those headaches, I remember thinking that I would do or take anything to get away from that pain. Anything.

Those around me didn’t understand. Chronic pain is largely invisible. I would look fine but my head would be pounding. I was told just to suck it up and keep going. Mostly I did. There were days when I would sit in a dark office until someone on my staff came to get me to see a patient. Then it was right back in the dark room.

At 45, something happened. Maybe it was male menopause. I have no idea. For the next 10 years, I rarely had a headache. At 55, they came back but not nearly as bad or as frequent. I still occasionally have to take an Excedrin but I don’t have to carry them in my pocket all the time. I can live with what I’ve got now.

But here’s my point: Pain can get so bad that you will take anything to make it go away. You’ve got a problem and there’s a pill that takes it away? You will take that pill. You may continue to take that pill if the pain continues.

Our country is in the midst of an opioid epidemic. We must do something. We must take ownership of our chronic pain. We must actively pursue control of our own condition.

Addiction is real and requires long term intervention. For many chronic pain conditions, my profession, physical therapy, is an effective non-pharmaceutical option but with copays and deductibles PT can be quite expensive. It’s a whole lot easier to simply take a pill than to exercise and work to get better.

I managed to escape that trap with my headaches but I’ll never know if I was lucky or strong. Just remember this—it can happen to anybody. Those opioid addicts can be your neighbors, your friends, your family.

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