Chronic Pain Patient Abandoned by Doctor Dies
www.painnewsnetwork.org/stories/2016/12/22/chronic-pain-patient-abandoned-by-doctor-dies
This will be the first Christmas that Tammi Hale spends without her husband Doug in over 30 years.
The 53-year old Vermont man, who suffered chronic pain from interstitial cystitis, committed suicide in October after his doctor abruptly cut him off from opioid pain medication.
“His primary care provider kept trying to wean him off his opioid therapy, which worked at higher doses,” says Tammi. “My husband ran out (of medication) early a few times, so the doctor cut him off completely one day. Six weeks later he took his life as no medical establishment would treat his chronic pain.”
We’re telling Doug Hale’s story, as we have those of other pain patients who’ve committed suicide, because their deaths have been ignored or lost in the public debate over the nation’s so-called opioid epidemic. Patients who were safely taking high doses of opioids for years are suddenly being cutoff or weaned to lower doses. Some are being abandoned by their doctors.
“I believe it will get worse with time. The docs are simply more interested in not risking their licenses than in treating chronic pain,” Tammi wrote to Pain News Network in a series of emails about her husband’s death.
Depression and suicidal thoughts are common for many people living with chronic pain and illness. According to a recent survey of over a thousand pain patients, nearly half have contemplated suicide.
DOUG HALE
But the problem appears to have grown worse as physicians comply with the “voluntary” prescribing guidelines released in March by the Centers for Disease Control and Prevention, which have been adopted as law in several states. Many doctors now fear prosecution and losing their medical licenses if they overprescribe opioids. Some have chosen not to prescribe them at all.
While federal and state authorities track the number of drug overdose deaths, no one seems to be following the number of patients who are dying by suicide or from cascading medical problems caused by untreated chronic pain. Some in the pain community call this “passive genocide.” Tammi Hale compares it to the Holocaust.
“The Nazis eliminated the sick and the weak first, right? Makes you wonder,” she says. “I realize my comments are harsh, but I believe the public needs to be aware of the dangers any one of us could be facing with this silent epidemic.”
Doctor Insisted on Weaning
Doug Hale began facing a life with intractable chronic pain in 1999, after a surgery left him with interstitial cystitis, a painful inflammation of the bladder. According to his wife, Doug tried physical therapy, antidepressants, epidurals, nerve blocks, TENS, cognitive behavioral therapy, and several different medications before finally turning to opioids for pain relief. High doses of methadone and oxycodone for breakthrough pain were found to be effective.
But a few years ago, Doug’s primary care provider (PCP) started urging him to wean to a lower dose.
“The PCP insisted on weaning. Although Doug clearly had documented malabsorption issues, the PCP persisted on weaning. The pressure to wean was unbelievable,” says Tammi.
“It came to a head in May of 2016. The PCP gave Doug one month to wean completely from 120mg/day of methadone and 20 mg/day of oxy. We knew this was impossible.”
Tammi says Doug checked himself into a 7 day detox program, where he was weaned to 40 mg of methadone a day. The doctor agreed to prescribe that amount, but it was not enough to relieve Doug’s pain. He started taking extra doses.
“He ran out a week early in late August. The PCP abandoned Doug, stating ‘I’m not going to risk my license for you. The methadone clinic can deal with you.’”
But the methadone clinic refused to treat Doug because they saw him as a chronic pain patient, not as an addict. “Had he turned to street drugs they could have treated him, but because he didn’t break the rules they couldn’t help,” Tammi explained.
Doug tried to detox at home, which Tammi calls a “brutal” experience. On October 10th, after being turned down by other healthcare providers, Doug went to his former doctor one last time to beg for help and was refused. The doctor said again that he didn’t want to risk his license.
“Doug left the office still thrashing in pain and despondent,” Tammi recalls. “The next day, my dear, sweet thoughtful husband of 32 years; a father, son, brother, uncle, and friend, well loved by many, dragged a chair to a remote spot in our back yard. A spot we could not see from the house, the road, or by the neighbors.
“He shot himself in the head to escape his pain. He made sure we could still live in our home and not be plagued by gruesome memories. I just wish the medical establishment had an ounce of the compassion that he did.”
“Can’t take the chronic pain anymore. No one except my wife has helped me. The doctors are mostly puppets trying to lower expenses.”
“Can’t take the chronic pain anymore. No one except my wife has helped me,” Doug wrote in a suicide note. “The doctors are mostly puppets trying to lower expenses, and (do not accept) any responsibility. Besides people will die and doctors have seen it all. So why help me.”
Tammi says she has been comforted by an outpouring of love and support from her family, friends and community. Doug’s suicide surprised many.
“Doug did make vague references about suicide during the summer due to the desperation and pain. He was just such a tough guy, he survived so much that my reaction, and others after the fact, was no. Not Doug. He’s like the bionic man. Too much of a warrior to give up,” said Tammi.
“At his memorial so many people commented on what an inspiration he was to them. To graciously bear the path of pain and his never-give-up attitude made them reevaluate their own daily issues. I guess you could say his legacy was love and to never quit.”
Tammi consulted with a medical malpractice attorney after Doug’s death, who told her the chances of winning a lawsuit against the doctor were slim. The cost of legal action would have also been prohibitive, after so many years of dealing with Doug’s medical expenses.
Tammi and Doug may never get their day in court, but she is determined to share his story in the hope that patients, doctors and regulators learn from it.
“My promise to him was to share with others. He was thrown away like a piece of trash, but his life and the life of all humans is precious. All patients deserve to be treated respectfully,” she wrote. “Hopefully some changes will come in time before the holocaust grows too much larger.”
Filed under: General Problems
I’m so sorry for your loss…I live with Cronic pain and wonder some days is it worth it? Please know that your in my heart as well as your husband….I know he would rather be here with you then waiting for you
Dang it!I don’t think what wrote is going to post so will try again.
Mary, I truly understand and agree . I wish I had gotten to know you before this constant threat. Those who know and love you will lose a very special person who cares about others and is willing to give of herself. Have a very special Christmas with your husband and loved ones if you can. Hopefully you will have a blessed new year with limited pain and be one of the few who are able to keep your meds. Peace and gentle hugs to you. Connie
(I of course wasn’t able to ‘re-type the same post as was lost in cyberspace but I tried to get the same feeling across)
Mee too,Connie,,,,JMO,, i purposely do not make new friends now a days,,,knowing all to well,,,any day my meds will be taken,,,,not if,,,,they will be taken,,,sooo in a effort to not hurt a good person,,a new friend,,,i choose not too,,Connie knows this ,,,as well as many others i have met along the way recently,,,they say ,,”what a bitch”,,not knowing the true reason why,,
JMO,,,Being x-mas and all,,and being a non practicing catholic,,,kinda a minor ironic,scenario,,Jesus died for/from the sins of others,,,just like all of our fellow chronic pain humanbeings,,,,maryw
See,,,no-one understands,,,,,its not that this wonderful man wanted to die,,,or leave his family,,he just wanted his physical pain stopped,,,and death was his ONLY option,to stop his physical pain,Its not normal for any humanbeing,or animal to want to live their remaining life in constant physical pain from a medical condition,,the dea,cdc,hhs,doj,,allof them,,should be charged w/murder,,,,plain and simple!!!!!!Even nurses whom work in pain management don’t get it,,,they think its funny to take away our meds or set-up patients to get them kicked out of pain management,,,My doctors nurse in constantly tryen to set me up,,,its a joke to them,,,,Only my doctor gets it,,,and i have told my doctor,,,if my medicine is forcible taken from me,,i will stop my physical pain via death,,exactly like this innocent soul did ,,,my gun is always loaded ,,whilst in the house,,,we have no children to worry about accidently getting into them,,,My husband also fully understands,,my life,,,my choice to end it if forced to endure physical pain,,,it not normal to live life in constant physical pain,,,,when there are MEDICINES to lessen that physical pain,,,, Soo far,,,i doo have my meds,,thank god,,,,,,,,,maryw
I am truly sorry for your loss. I am a chronic pain patient and I don’t know what I would do with out my pain medication. I suffer from fibromyalgia, degenerative bone and disc disease, diabetic neuropathy, osteoarthritis, psoriatic arthritis and psoriasis which is painful and very dangerous because I get patches on my lower legs and feet, my toenails are even affected and being diabetic could cost me my leg, I also have scoliosis. Two years ago I was waIking in my own home and the tendons in my right ankle tore in half There was no place to go but straight down and I broke my ankle and fibula in my right leg. When I was in school I was an athlete and had sprained and damaged my ankles and knees constantly. I had to have my ACL replaced when my son way 18 months old because I slipped in some water. It wasn’t even a bad fall. The only thing my doctor’s have given me as for a reason is the damage I did to my body in athletics in school. I have to be tested for lupus after the first of the year. It isn’t that my PCP wanted to wait. That was my decision. I didn’t want to be more depressed during Christmas and the New Years. I have been diagnosed as manic depressed, OCD ,PTSD and I have sever anxiety with anxiety attacts. My pain is so bad even with my medication it’s a 7 on the pain scale. Some days I can’t do anything but sleep through the pain. I see a pain management doctor and she is very tough. I am prescribed, extended release morphine 30 mgs every 12 hours. And oxycodone 15 mgs. Every 4 to 6 hours I have to go every month, I am drug tested she also test for the amount of medication in my system to make sure we are not taking extras but to make sure we are taking the medication. I see a therapist. Right there in her office, which I am so very greatfull for. But I know of some people’s pain management doctor being (sanctioned ?) in trouble for over prescribing pain medication. I know this doctor he was my PCP before he desided to open his on office as a pain management doctor. When he was my pcp doctor he all but refused to prescribe any pain medication. He did treat my anxiety and depression and gave me Flexeril for muscle spasms. My pcp that I have now was willing to treat my pain up to a point because she is the only doctor I have had for 8 years and the medication wasn’t working any more I adore her and I am thankful for her compassion. She got to a point that she just didn’t know what to do to help. She just could not prescribe stronger meds, I have used the same pharmacy for two many years to remember even in school my mom always got our medication at the same walmart. A friendly tip always peal the label off you pain and depression/anxiety medication bottles. On August 8th 2008 I was being released from the hospital it is easy to member because it was the day before my birthday. My best friend had my son and she got to my house while I was waiting for my release paper work. She called because my home had been robbed the went through everything you could tell they where looking for certain stuff because they went through every drawer in the house and the dressers. I got very lucky because my doctor was in my room giving instructions when she called so I could get home asap. He was able to call and verify before I left the hospital so he did give me a script for medicine. I see all these people that are addicted trying to get these pain medications and anxiety medications. I have the medication xanax for my anxiety attacts and 3 different antidepressants. I have read and people like this gentleman and even me our body’s do become dependent but we are not addicts. There is a difference. People that don’t have chronic pain say stupid and hateful things. I cannot tell you how many times I have wanted to sucker Punch someone for telling me I don’t look sick, to get up and exercise more, my all time favorite it’s all in my head, if it was all in my head If would take a friggin aspirin! I make sure I don’t take extra because on bad days it would be nice to be able to just to make it tolerable, I have.a heat resistant, fireproof little safe I keep my important papers and my medication in. There are two keys but I don’t one have one. Every Saturday I fill a weekly medication container there’s always another person in the room when the safe is open me and one of the people that have a key. My 75 year old aunt that stays with us and my husband have the keys. My aunt is a retired RN. I am so so very sorry for. Your loss I can see me doing the same thing. What makes it hard on those of us like your husband and others like myself that yes after time our doses have to be adjusted but not to get high. But we are not the ones overdosing the addictes are the ones want to get high. God Bless you and bring you peace during Christmas and the holiday season. I will pray for you.
My heart goes out to this family. Remember the legacy of love that he left, hopefully it will ease your pain a little.