America’s Other Epidemic: Chronic Untreated Pain
The death of Prince, who apparently had a Percocet problem, and a 2016 presidential primary peppered with New England town halls that delved into increased heroin overdoses and prescription drug abuse have converged to create what CNN’s Dr. Sanjay Gupta calls “a public health epidemic.” Drug addiction is 2016’s big nonpolitical story. CNN aired a special, “Prescription Addiction: Dead in the USA.” The Senate passed the Comprehensive Addiction and Recovery Act to provide grants for treatment and improved monitoring. The House also is working on legislation, with funding expected later in the year.
Grant Smith, deputy director of national affairs for the Drug Policy Alliance, sees Washington moving in the right direction by “treating drugs as a health issue” and “addressing head on some of the harms associated with opioid use.” Some 78 Americans die from opioid overdoses every day, CNN reports. Its special “Prescription Addiction” related some horror stories — the football star who was popping 1,400 opioid pills a month; the teen who suffered irreversible brain damage after he started experimenting with friends; the teen who died of an accidental overdose after he got hooked on drugs prescribed to treat a football injury. Gupta cautioned that there is “legitimate pain that warrants” a prescription, but for a short period of time. Given the rise in overdose deaths, the media should warn the public about the risk that comes with painkillers.
I see a downside to coverage that has turned painkiller addiction into a media chew toy. This narrative focuses on doctors who for a variety of reasons seem to have overprescribed medication, and on patients who at their own peril try to game the system to get drugs to feed their addiction. There is little room in this narrative for the many individuals who do not get the pain control they need. I am talking about older people who need better end-of-life care. Many start phobic about painkillers, as they fear being drugged and listless. They may not realize that good palliative care can make them more able to cope in their remaining time. (As for those few who might overuse medication, who cares? They’re not going to take up robbing banks.)
I called Eric Chevlen — a friend, Ohio pain medicine specialist and medical oncologist — to get his take on the new big story. Chevlen sees another problem in America — untreated pain. Poor people and uninsured individuals are less likely to get the relief they need. Also, people who have hard-to-diagnose ailments (like fibromyalgia, which mostly afflicts women) may go years before receiving available treatment.
Because they’re debilitated, people who don’t get the pain control they need may not feel like speaking up, so you don’t hear their stories. You hear of addicts who go to the emergency room in search of a fix, but not about those who suffer in silence.
When it comes to pain control, Chevlen told me, “hardly anybody gets the right amount.”
Chevlen has two concerns about the new approach in Washington. First, new Centers for Disease Control and Prevention guidelines are labeled guidelines, “but they’re going to be interpreted as mandates.” Second, Chevlen also believes that pushing patients away from opioids and toward anti-inflammatory meds carries a different risk — toxicity. Some patients will die from long-term organ damage, a side effect of pharmaceuticals, but their deaths won’t be counted as overdoses.
I know that this column will spur readers to write about the horrible tragedy of a child, or other loved one, who got sucked into opioid addiction and into a downward spiral that ended in death. Too many families can point to a doctor who didn’t keep a careful eye on what he prescribed. Or maybe the doctor was careful, but opioids had taken an ineffable hold and street trade made other drugs too available. Their stories are powerful, and serve as a warning. But there are other stories too — tales of people racked with pain that robs them of the joy of living. As Chevlen warned, “When we’re treating pain inadequately, fewer people die of opioid deaths.”
Filed under: General Problems
Because of this epidemic i a chronic pain patient with severe spinal injuries and related permanent disabilities cannot get anything that’s an opiate. I am 50 and i have given up trying to get legitimate compassionate care. I have been labeled a drug seeker right after i moved to Spokane and injured myself in a fall on black ice. I don’t know why i was profiled and treated the way i was. My diagnosis was bruised coccyx all i got was an x ray and a script for tramadol. My new pc i followed up with wouldn’t treat me for pain either. She gave me advice tho, get a donut to sit on. For six months i lived in suicidal agony going in week after week after month until she ordered the MRI that revealed the extent of my injuries my disc was ejected from my spine on impact several disc collapsed on top of each other and eventually fused together. And even tho i was told i needed surgery or I’d be in a wheelchair i was told no because of i had gained 70 pounds after my injury and i smoke. I got a second opinion from another surgeon who wouldn’t operate for the same reasons but coerced me into starving myself to lose weight that if i really wanted this medically necessary surgery for quality of life I’d start starving myself. I started starving myself and throwing up after i would eat from guilt and shame but i got my BMI from a 43 to 30 the surgeon said he’d have a date for surgery in 2 weeks. That was last June to November he bs’d me that entire time. Id call and be told by front desk reception that no there was no date because i was to fat for months in untreated agony. I was in shock because this surgeon told me to my face 2 weeks and then didn’t put the prior auth in. I don’t know why he continually lied to me and fat shamed me i could hardly move i was hurt so bad and he wouldn’t give me anything for it either. I called my insurance and told them all this there was a grievance made and i was allowed to see a surgeon in Seattle at my own traveling expense. I had my medical records sent to a surgeon in Seattle who wanted to see me as soon as i could get up there. I saw him a few days before Christmas and he said i should have never been able to get up and walk from the injury i sustained. If he could have done it he said he’d operate on Christmas day. This past February i had 2 spine surgeries in Seattle over 3 years after i was inured. I had a new disc put in between the disc that fused but had to be chiseled out for it to be inserted and a lumbar fusion and a laminectomy with cadaver bone to shore up my spine. I also have severe spinal stenosis and was born with a neural tubal birth defect known as partial spina bifida.I’m considered high risk also because i have been using cannibus to keep me from taking my life. I am very suicidal and want to kill myself everyday these days. I also use to be a heroin addict for which i served my time and deemed rehabilitated by the California State prison which was over a decade ago and i did long term treatment and therapy working on my issues that led to that addiction. I am not a drug seeker if i wanted to get high i certainly wouldn’t go to a doctor or an er. For a few pills? That’s not getting high or worth the time invested. In California when i was in pain it was treated with opioids and i have never abused my medication there’s no history of prescription abuse but now here i have been pushed into a corner and can’t get legal help for it. They are essentially pushing me back into a street addiction and they wonder why this is happening? It’s happening because they have created this stereotype that any type of opioid legal or not makes us addicts. We are all drug seeking fakers that don’t deserve any quality of life. It wouldn’t matter if i had stage 4 cancer they won’t touch me just keep giving me the run around. Nothing for my fibromyalgia which has gotten much worse from the surgeries nothing for the flare ups i get from the recurrent pleurisy and nothing for the headache i have every day that turns into migraine more often than not and causes vertigo that lasts for days. Yesterday after i was discharged from mental health care because my case is too complex and wasn’t even given refills for my depression and adhd. Just cut me off. I quit western medicine. I’m done trying to find someone to help me. I am taking kratom for pain and energy and pot to help me not kill myself and cbd nano drops that also helps with my pain and mood. I am going crazy tho from pain these things only take the edge off but until it kicks in i am thinking crazy thoughts the pain is pushing me to lose my mind. I am so angry and hurt in my heart over how I’ve been treated since i moved here. My doggie gets better healthcare than i do which im both grateful for and jealous. Its not fair that we are going thru this and we area powerless to stop it. We aren’t physically able to protest or riot or march on Washington we can’t even fight for ourselves. All the letters and emails and phone calls aren’t going to get the media attention we need in order for our voices to be heard and since our voices aren’t being heard we are being walked all over. We have no rights where this is concerned. I am willing tho to protest and march or even riot if necessary. We could all plan for a certain day to get together we could organize protests across the nation by gathering those like us in our individual cities if we can gather enough together to help us fight for our right to better healthcare we could get that media coverage. Whose with me? Email me daisy1567@gmail.com