Chronic pain and the opioid crisis. They’re always linked in the minds of the media and the government. In the past, I’ve written quite a few angry posts about the way chronic pain patients are being treated. It was really more of a vent session for me because I had to give up my pain treatment thanks to constant harassment from the state, insurance company, and pharmacists. My pain was decently controlled by a very small amount of hydrocodone, but in the end, the amount didn’t matter. What mattered was the opioid epidemic and the addiction of others.
Chronic pain and the opioid crisis
Why pain patients are being punished for the actions or disease of someone else will always be a mystery to me, but over time I have learned that it’s not the fault of people who live with addiction that pain patients are being treated like this. Fault and blame are complicated to pin down, but today I want to talk about one of the biggest myths that have led to the opioid hysteria and demonization of people in pain.
The myth of the innocent person that becomes an addict
This is how the narrative usually goes. Some perfectly innocent person goes in for dental treatment, or breaks their leg and goes to a doctor. The dentist/doctor feels compassion for this person’s pain and gives them opioid pain medication. The person goes home and takes the medicine the doctor gave them. The medicine feels so good they keep taking it even though they don’t need it anymore. They try to stop, but they just can’t. They go back to the doctor/dentist claiming they’re in pain because at this point they are fully addicted after a mere 30 days.
Eventually, pills become less available so they go to the streets to feed their addiction. Street pills are dangerous and eventually they overdose on something badly manufactured in China. This is all the fault of the doctor/dentist that prescribed the original pain pill or the drug company that produced it. It’s definitely not the responsibility of this wonderfully innocent person (who is white, black people don’t get this kind of narrative because pain treatment is racist).
This tragic story is why people in pain shouldn’t ever get treated for it, they’ll become addicts and die on the street!
So what’s wrong with this story? It’s not true.
That innocent (white male) person who went to the doctor/dentist was statistically likely to already have a substance abuse problem.
People who abuse pain medicine already abuse other substances
To begin, Studies found that:
Illicit drug use was a predictor of pain reliever misuse across all age groups.
In other words, people who do become addicted during pain treatment already have problems with drugs and alcohol. If fact three-fourths of them had already misused medication such as benzos and inhalants, long before they misused pain killers. They were already experiencing addiction.
Additionally, according to a study published in the Annals of Internal medicine:
Misuse and use disorders were most commonly reported in adults who were uninsured, were unemployed, had low income, or had behavioral health problems. Among adults with misuse, 59.9% reported using opioids without a prescription, and 40.8% obtained prescription opioids for free from friends or relatives for their most recent episode of misuse.
In other words, opioid misuse is multifaceted and it’s connected to America’s lack of healthcare and mental health treatment as well as poverty.
Opioid misuse was most commonly reported in adults who were uninsured, unemployed, had low income, or had behavioral health problems. There was no tie to chronic pain. Click To TweetThe opioid epidemic has nothing to do with chronic pain
Chronic pain and the opioid epidemic
A review by the Cochrane Library to study opioids for long term non cancer pain found that treatment with long term, high dose opioids leads to addiction rates of less than 1%. People with chronic pain become addicted very rarely. Which is why the solutions being implemented to fix the opioid epidemic aren’t working. In fact, according to the CDC while prescriptions opioids being prescribed have gone down dramatically, the total opioid deaths have risen due to illegal fentanyl and heroin. People with chronic pain live and die in agony and it’s not even helping.
What it’s like to be a victim of the opioid hysteria
Chronic pain is synonymous with addiction thanks to the opioid epidemic. Pain patients are terrified of telling doctors that they’re in pain because they don’t want to be labeled as an addict. If the doctor doesn’t believe their pain they can write in the chart that the patient is addicted, and that patient will never be treated for pain again. Those records saying they are an addict will follow them everywhere and could ruin their life. Doctors have a lot of power over people in pain. Also, considering the gender and race differential in how pain is treated, women and people of color have to worry even more.
Additionally, long term untreated chronic pain has some severe consequences. Ignoring chronic pain has never improved someone’s health, it has only damaged it. Pain patients are begging doctors, the government, insurance companies, and politicians to stop believing the myths.
Believe us. Treat us. Don’t let us die.
Sources
Science Direct. “Prescription pain reliever misuse prevalence, correlates, and origin of possession throughout the life course.” Mowbray, Orion and Quinn, Adam.
Annals of Internal Medicine. “Prescription Opioid Use, Misuse, and Use Disorders in U.S. Adults: 2015 National Survey on Drug Use and Health.” Beth Han, MD, PhD, MPH, Wilson M. Compton, MD, MPE
Cochrane Library. “Opioids for long-term treatment of noncancer pain.” Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, Schoelles KM, Chou R.
I thank you so much for this post. It took me years to find Doctors who saw my pain. I am one of the people who, like yourself speak out for Pain Warriors. I go to Pain Management monthly for Norco, Tizanidine ( muscle relaxer) and a Voltaran Pain Patch for my Spine. I have Chronic Daily Migraine, have had 3 Fusions to my Cervical Spine, 1 C Mobi Disc Implant, 4 Blown Discs in my Lumbar Spine. I am never not in pain. I pee test for drugs I’ve never heard of and I worked for Doctors for 20 years before I had to be on SSA Disability because there is no way I can work. All of this, I’m not proud to say, has cost me 3 marriages as I was told I was a burden and not “ fun” anymore. I lost everything at one point and was homeless, living one place to another. Chronic Pain has a very high price with zero help. Twelve years later, I am in Housing. A lovely, safe apartment. Ten minutes from my children and grandchildren. I pray big for others like myself.
Lisa I am so sorry to hear all that you’ve been through, chronic pain really does take away so much from us. I’m so glad that eventually things got better and that you’re able to get treatment.
How do you go on when the pain rules everything? Your body, mind and emotions. I have fibro, osteoarthritis, degenerative disc disease, scoliosis, sciatica and osteoporosis and they keep lessening my pain meds, spend most of my time just existing in a bed in pain 24/7 with no life, no real help! I am scared because there’s no cure for any of my problems, dont know if i can handle it getting worse than this, why won’t they help me, help us?
Thank you for this post, so important and timely. I hadn’t ever thought about being perceived as seeking pain relief for the wrong reasons, but I have a GP that knows me well and trusts me. I imagine many people don’t have that experience though and have to work hard not to get that label.
A lot of people have troubled being labeled as an addict in the hospital, where they have doctors they don’t know. ER doctors especially like to claim that every women that comes to the ER in pain is either hysterical or an addict. I was told I was faking a kidney stone once, even though it was visible on the CAT scan. It’s a huge mess.
It’s only in the last year that I’ve gotten to understand more about the opioid crisis because I’ve lived in two countries (England and India) where I’ve never experienced an issue. I’ve never been denied pain meds and in fact this whole situation surprises me that people can be treated this way.
I’m glad I read this – it’s helped me understand things better.
I’m so jealous! It’s such a mess here. People being denied medication when they’re dying because of the fear of addiction, it’s ridiculous.
Hi Thank you for this post/article
I have worked in healthcare for 20some years. All disciplines and areas med/surf, tele and oncology. Hospital on the floor and at the desk. Doctors offices front and back. Home care in office and in clients home. In all these years I have never seen or heard of the suffering of pts and the lack of care that follows the opioid debacle. Addicts are getting better treatment and care than even terminally ill. Hospice and palliative care should not be stress and suffering but compassion and pain relief. I have had 5 right total knees (3 due to infection which means 2 additional surgeries for each infection) 4 left total hips, thoracic vertebral osteomyelitis t-9-12, c-6 with radiculopathy, mva with fracture t-3, failed ankle fusion with crps, bilateral rotator cuff tears (unable to repair due to crutch use). My pm keeps pushing me lower and lower. He wants me below 90mme. How. Why and when will I just give up. He’s pushing an scs implant. If I don’t he may drop me? He admits he doesn’t know anything about them. He tells me if I want to stop opioids I would do this. I will never be off opioids they work. I am prescribed meds off label. I don’t want another surgery. I have had recalls on my hip. Fda came out with reports of problems in spinal cord stimulators. I went to a Don’t punish pain rally. I couldn’t move for a week after. I have joined the fight because I am dying. I have joined the fight because I have no choice. ??
Michelle, it sounds like you have been through so much and dealt with a lot of pain. I hope your doctor will still keep treating you. Those spinal cord simulators have worked for some people, but are really dangerous to others.
Thank you for your reply. I like the ideas here. I have found out yesterday that dr will now taper me since I wrote him I do not want the scs. Go figure……I found this out when my records were sent for another pm to consider taking me on. Good luck right?
Oh no! I’m so sorry. He just sent your records to someone else?
It was my request as I’m looking for an online clinic. Can’t drive the 4 hrs round trip. But nowI am gonna call and get my own copies.
I am due for a refill tomorrow. I called asking for a refill ONE day early bc of newly diagnosed hip degeneration and c 2/3 spinal issues that had me in tears more than once in November. The PA said I had to come in so we could talk about my pain meds since there is evidence that Narco doesn’t help FB. Seriously? This year alone I have had 1 ER visit, 4 separate visits for X-ray, 2 MRI,s and countless doctor appts. I feel like I am losing my mind. And she now is going to sit with me on Friday to discuss my pain med. WTF ! I have incurred $5,000 in debt this year. I sit at a 5/6 all the time and now with COVID – any surgery is out till next summer.
I hate being in pain. I hate being made to feel like an addict. I will begin drinking heavily if they take me off.
We know SO little about FB — but sure — YOU tell me about what works and doesn’t work.
????????????
I hate that myth that people keep saying. How do they know it doesn’t work for FB there’s never been an actual study. In fact, they’ve never tested opioids on people with FB in the long term, because it was considered too cruel to have the control group go without treatment. I think Fedupwithfatigue.com wrote a post about it last year.
I couldn’t agree more with this article. In Australia, doctors now have to apply for a government authorisation to prescribe a drug of dependance. My authorisation has been denied because I am too young to be taking a strong medication and haven’t tried enough other medications in their opinion, despite the many treatments I’ve undergone for my chronic migraines. My diseases do not discriminate based on my age! And I don’t want to be a guinea pig and try multiple other medications with varying side effects when I have one that works well for me. My doctor treats me like an addict also, which I find appalling. I’m rationing my medication, suffering just to make it last longer in case I have a worse day in the future. I don’t even take full tablets, I’ve always taken a small dose, but that doesn’t seem to matter. It’s really disappointing 🙁