August 12, 2019

 

Free photo 2106866 © Chrisharvey – Dreamstime.com

A NIH quote states that “Chronic pain is often defined as any pain lasting more than 12 weeks. Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different.  Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain.”

As I am sure you all must think that pain dominates my life and you are right.  I go to bed at night worried about how much sleep I will get and worried about how much pain I will have when I wake up.  I worry about what I will be able to accomplish the next day.  Will the pain be overwhelming?  Will I be able to accomplish simple household tasks?  Will I be able to concentrate on reading a book?

My next family doctor appointment is in October.  The anxiety, stress, and worry has already begun.  Will this be the appointment when he decides that I no longer need pain medication?  Will this be the appointment when he decides my pain is insignificant?    Will he agree with the report from the Sports Medicine Rheumatologist who diagnosed me with arthritis in my left ankle and severe arthritis in my right ankle, arthritis in both knees, bone spurs and chondrocalcinosis in both knees, arthritis in both hips and in my spine.  Will this diagnosis be enough to allow me to continue the use of pain medication?

How do we impress upon our doctors the severity and frequency of our pain?  How do we make them believe that we are truly suffering and not just after “drugs”?  It is a proven fact that chronic pain sufferers do not run from doctor to doctor trying to obtain duplicate prescriptions.  Chronic pain sufferers do not have the energy to indulge in this form of drug-seeking.  Who is going to be an advocate for people who suffer from chronic pain?  Who is going to help them deal with all the problems associated with chronic pain?   So many questions and so few answers.

Pharmaceutical salespersons love to push new drugs and often give doctors’ perks in exchange for prescribing their drugs.   The medical profession is in the process of bad-mouthing opioids and taking pain relief from people who are in agony.   The medication that the drug companies push and doctors prescribe as a substitute for opioid medications are not the “be all” and “end all”.

Since the Centers for Disease Control and Prevention published its guideline for prescribing opioids for chronic pain in March 2016, pain patients have experienced increasing difficulty getting needed opioid medication due to denials by pharmacists and insurance providers.  Things have gotten so far out of hand that certain groups are threatening to sue the drug companies for making opioids.  Obviously, anyone involved in making opioids virtually impossible to obtain has never experienced intense pain.

According to data published in an article called  “Overzealous use of the CDC’s” the opioid prescribing guideline is harming pain patients.  The CDC suggests that illegally manufactured fentanyl, its analogs, and heroin are responsible for well over half of all overdose deaths. Stimulants like cocaine and methamphetamines are responsible for another third. Deaths related to prescription opioids come next in line, although many of those who died were not the intended recipient of the prescribed medication. In addition, most deaths involve multiple substances that are used in combination, often including alcohol.

The vast majority of people who report misusing prescription opioids did not get them from a doctor under medical supervision, and as many as 70 percent reported prior use of substances like cocaine and methamphetamines.

Confusing the abuse of opioids with their legitimate use and treating all opioids whether illegal or a legal prescription the same is punishing and stigmatizing patients for whom opioid painkillers are necessary and medically appropriate.  It is abusing patients who would not be able to get out of bed in the morning were it not for the pain relief of opioid medication.  Most legitimate users of opioids will tell you that the medication never takes the pain away completely but it makes the pain bearable.

What is very concerning is that some physicians who specialize in pain management are leaving their practices.  Others are tapering their patients off of opioid medication only because the doctors are afraid of losing their licenses or facing criminal charges.  This happened to me.  I had to change doctors because my family doctor, Dr. NoName accepted another position in a hospital.  I had a month to find a new family doctor.  At the time I thought I was very fortunate.  The new doctor, Dr. Eve was wonderful, capable of listening to my health problems, not afraid of referring me to a specialist and had no problem continuing my prescription for an opioid medication to help deal with my pain.  Three years later I was told a fairy tale.  This lovely doctor who I trusted and believed to actually be concerned about my health issues told me she was leaving her practice.  I had to find yet another family doctor.  Dr. Eve informed me that she had registered me with a new family doctor, Dr. Creeper.  She promised me that he would prescribe for me the same medications that she had prescribed.  You can imagine my horror the first time I saw Dr. Creeper.  He accused me of being a drug addict.  He told me that no one needed opioids for pain relief and that he was going to stop all the doctors in the clinic from prescribing opioids.  He went on to tell me that all the affluent people in our town were addicted to opioids.  Dr. Creeper is too kind of a name.  Well, talk about feeling betrayed.  Three months after leaving her practice Dr. Eve was back accepting new patients.  She would not accept former patients.  This was Dr. Eve’s way of getting rid of her patients who required opioid prescriptions.

According to Overzealous use of the CDC’s opioid prescribing guideline is harming pain patients  The laudable goal of these laws and policies is to stem the tide of unprecedented overdose deaths and addiction in the U.S. But here are three interesting facts: Opioid prescribing is currently at an 18-year low. The rate of prescribing opioids has dropped every year since 2011. Yet drug overdose deaths have skyrocketed since then.

Certainly, doctors have the ability to note the difference between someone in pain or someone looking for a high.  To punish 71-year-old women who are experiencing pain by withholding pain medication is disgusting and cruel.  In fact, withholding pain medication from anyone who is living with chronic pain is diabolical.

My hands are tired and I need to get some sleep so I will get off my soapbox and crawl into bed.  For the last two nights, I have been waking up every two hours because of the pain.  Sleep deprivation is not nice.

I have been negligent in continuing the Monday evening chats.  Since many people are busy outdoors during the summer months I have decided to continue the chats beginning in September.  The time and date will be announced in a week or so.  If you are suffering from an autoimmune disease and/or chronic fatigue and chronic pain please feel free to join our chats.

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