A Pained Life: When There is No Cure

By Carol Levy, Columnist

There tends to be a misunderstanding in the minds of many, including doctors, that people who take opioids for their chronic pain believe it will “cure" their pain.

The idea behind a narcotic is the dulling of pain, or if you're lucky, stopping it in its tracks. It is not designed to “cure” anything.

Patients with kidney stones, as an example, are often given morphine, not because it will dissolve the stone, but because it will help reduce the pain.

When there is no cure, when the ultimate biological mechanism behind the pain is unknown, and when the patient is in pain, what is a doctor to do? What is a patient to do?

To me the answer is simple. They work together to find a drug(s) that will help relieve the pain. Often that means an opioid..

Trigeminal neuralgia (TN) is a good example.

Although theories abound as to the cause of TN, even the most long lived school of thought; that a blood vessel is pressing against the nerve, is not accepted by many in the neurosurgical community.

Some patients are helped by surgery, but a large portion do not and get little or no relief. In addition, many develop phantom pain -- called Anesthesia Dolorosa -- which is truly awful and life destroying in its own way. Does that mean a doctor should offer nothing to try and help? Or is this the time to offer an opioid?

Sometimes my Anesthesia Dolorosa pain is helped when I take my prescribed narcotic (codeine). On a really good day, which is very rare, it even helps my eye movement and usage pain.

Is it enough to make me "able"? No. The pain is still there.

Then how can I say it is helping?

It encases me in a layer of numbness, the pain somewhat outside of me.

Do I enjoy it? (A question asked by way too many) Absolutely not. The codeine swathes me in a net of sticky cotton, a sensation of suffocation and a loss of boundary. But the pain is farther away from me and I can breathe.

We have chronic pain. We know, for most of us, there is no cure.

But too many are trying to take away the one thing that helps some of us get freedom from the pain, even if only a fingertip full.

Please, those who say since there is no cure in a narcotic they should not be given; please, please understand. Even a soupcon of relief is acceptable when that is all there is.

And often, all there is is a narcotic.

Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 30 years. She is the author of “A Pained Life, A Chronic Pain Journey.”  Carol is the moderator of the Facebook support group “Women in Pain Awareness.” Her blog “The Pained Life” can be found here.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represent the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.