By Crystal Lindell, Columnist
Ok. Wait. Before you read the headline and send me hate mail, I just want to remind you guys that I am a pain patient. Just like you. So take a breath and let me explain.
So yes, the pain patient community needs to stop demonizing “addicts.” I know. I know. They make a great enemy. I mean, if it wasn’t for all those opioid addicts out there, we’d all be able to get the medications we need. Am I right?
But just as pain is complicated, so is addiction and so are opioids.
I recently wrote a column about my first time getting a lidocaine infusion, and it included a throwaway line about how I was hoping the treatment will help me get off opioids because, “I don’t actually love being high all the time.”
Dang. People were not happy I said that.
Apparently, there is this idea out there that if you are taking opioids like hydrocodone for legitimate physical pain, then you don’t get high from the medications. And if you are getting a high from them, then you’re an addict. The end.
Unfortunately, that’s not exactly how opioids work. There is no magic pill (yet) that we can take that relieves physical pain without also impacting our brains.
Part of the problem that people seem to have a very specific idea about what the word “high” means. There’s a common trop in pop culture that shows addicts in tattered clothes, lying in an alley with their eyes rolled back in their heads. But that is far from the full picture.
When I take a hydrocodone, even a very small dose of 2.5 mg, I get more relaxed, a little tired, and my reactions are delayed. That’s also a version of getting high. And pretty much everyone else on even a low dose of opioids is likely having the same reaction.
Personally, I have found that when the drugs don’t have that impact on you, it usually means your body is getting used to them, and it will be that much harder to quit taking them.
Look, I get it. The current mood of the country is that opioids are evil and must be stopped. And for people suffering from horrific chronic pain, losing what is often the only treatment that actually works is horrifying. It’s easy to just point to the people causing all the opioid hysteria (the addicts) and blame them. But it’s more complicated than that.
Because when a Ohio sheriff refuses to carry the opioid overdose medication Narcan, it doesn’t just hurt addicts. It hurts pain patients who may accidentally overdose too.
And when addicts start out taking these drugs because of physical pain, what right do we have to attack them? We started taking them for the exact same reason.
I know that many pain patients find great comfort in separating the idea of addiction and physical dependence, but I have to tell you something that I learned when I took myself off morphine — the two aren’t actually all that different.
When you are on 60 mg of opioids a day for years at a time like I was and then stop taking them, your body doesn’t care why you started in the first place. And even if you can get through the first week of hellish withdrawal with horrible flu symptoms, panic attacks, insomnia and diarrhea, your brain could still crave the drug for as long as two years. It got used to having opioids, and has to rewire itself to function without it.
Pain patients often take opioids hoping it will alleviate their symptoms and make them feel normal again. But guess what? Addicts take them for the same reason. At a certain point, they need the drugs just to feel normal because their brain doesn’t work right without them anymore.
And, while pain patients start taking opioids for physical pain, many addicts usually started taking them to relieve pain as well — it’s just that their pain is emotional. But anyone who has ever suffered through a truly tragic loss or heartbreak can tell you that emotional pain can be just as awful as any physical pain. We all just want to feel better.
What Can We Do?
I truly believe that the government should not be involved in our health care decisions and I’m against many of the new regulations that try to limit what doctors can prescribe. Whether or not you should take opioids is a decision that should be made solely between you and your doctor. And I know that the reason many people take opioids is because there are no other effective treatment options available.
However, pretending that pain patients somehow have a different response to these medications than anyone else is naïve. And the sooner we recognize how intense the drugs are, the sooner we can actually start looking at realistic ways to help pain patients as well as addicts.
So how can we move forward? Well, legalizing marijuana everywhere would be a good first step, but even that won’t help everyone. We also need more research into pain treatments that actually work as realistic alternatives to opioids. We also must approach addiction with the same compassion we usually reserve for physical health problems. Addiction is a mental health issue, and the key word there is health.
We need to take a hard look at how we treat addiction, and move into longer-term models that help people for years and include professional psychiatric help. Pretending someone can get over opioid withdrawal by solely going to Narcotic Anonymous meetings is like pretending someone can get over cancer by solely going to weekly support group meetings.
We also need to treat underlying mental health issues like the serious health problems they are, because when people get their clinical anxiety and depression treated correctly, they are less likely to try to self-medicate with drugs like opioids.
Perhaps the best thing pain patients can do is join the same team as the addicts we love to hate. Because if fewer people were abusing opioids, then maybe the government would stop trying to take them away from pain patients.
Crystal Lindell is a journalist who lives in Illinois. She loves Taco Bell, watching "Burn Notice" episodes on Netflix and Snicker's Bites. She has had intercostal neuralgia since February 2013.
Crystal writes about it on her blog, “The Only Certainty is Bad Grammar.”
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.