In 2011, at the height of my struggle with chronic pancreatitis and before my transplant surgery, my daily pain hovered at a 6 or 7 out of 10 on the pain scale even with strong opiates like Fentanyl and Oxycodone in my system. As difficult as it was to function through the pain, without these medications I would have been bedridden and suicidal. That’s not hyperbole – it’s fact.
Even then I was beginning to see the tide turning on how chronic pain patients were being treated, and while I was fortunate to have had a primary physician dedicated to maximizing my well being, I was often subjected to judgment, dismissal and disdain by others within the medical establishment who assumed that I was a drug-seeking addict. Despite diligently following all the “rules” such as taking my meds exactly as prescribed and getting my prescriptions filled by the same doctor every time, the suspicion remained.
But – and this is a huge qualifier – I was able to get the meds I needed to bring the pain down to a level that I could live with and ensure some quality of life. For far too many chronic pain patients today this is no longer an option. In our zeal to stem the bleeding from the opioid addiction tearing at our country, we have sacrificed the wellbeing of responsible patients who rely on certain opioid medications to simply function, and who deserve some measure of dignity and humanity from a healthcare system with the power to heal or harm.
Not everyone who uses prescription opiates is addicted. Those who take opiates on a regular basis become physically dependent on the drug and will experience certain withdrawal symptoms as the drug leaves their system. That is not the same as addiction. There are many non-addictive medications that pose the same risk for withdrawal if stopped suddenly – but doctors wouldn’t dream of putting a patient through such unnecessarily inhumane treatment in these instances. They would weigh the risk/benefit to the patient and if appropriate, titrate them slowly off the medication to lessen their discomfort.
After my transplant surgery, my pain was no longer crippling and I no longer needed high levels of narcotics. It took close to a year (after 7 long years of daily use) to titrate completely off both the Fentanyl and Oxycodone. Not because I was addicted, but because my doctor rightly understood the need for a gradual reduction to allow my body to adjust to increasingly lower levels in my system. It was not traumatic. It was not reckless. It was humane. And it was the kind of health care I deserved as a patient.
I am a huge fan of Dr. Lynn Webster, the author of the book The Painful Truth, and an expert in pain management who advocates on behalf of chronic pain patients. There IS a better way, as this article by two of his medical colleagues point out, and the time is now to course correct. Losing chronic pain patients to suicide or allowing them to suffer needlessly is not acceptable friendly fire. We can and must do better.