interviews Janice Reynolds, a member of the steering committee for The Pain Community.
There is a steady and continuing drum beat in the press and from researchers and commentators warning of the dangers connected to prescribing and using opioid pain medicine. In this mix are the usual research reports proclaiming the same debatable results.
There are two converging lines of research inquiry:
1) That prescription opioids are the gateway drugs to dangerous street drugs, most especially heroin.
2) That high doses of opioids are dangerous to pain patients, and the long term use of them doesn’t help reduce pain and exposes the patient to likely addiction.
The second line of inquiry conflates dependency with addiction. This confusion continues the canard that opioid medicines are extremely addictive and thus dangerous.
Ms. Reynolds believes the notion that OxyContin leads to street drugs rests on a bias that many commentators and researchers have against prescription opioids. She believes drug abuse doesn’t start with prescription opioids, but has antecedents in other substances, such as cigarettes, alcohol, or other commonly available substances.
Ms. Reynolds echoes a common complaint: Most of the criticism of legitimate prescribing and use of opioids comes not from physicians specializing in pain, but from addiction specialists.
This explains a great deal: if you’re always looking for addiction, you’ll see it everywhere, interpreting any use of addictive substances (opioids, coffee, cigarettes, even food) as true addiction. Yet there is a huge difference between habits and addiction, which is why addiction is considered a disease and habits are normal behavior. The line between them may never be clear, and dependent on your personal and cultural beliefs.
As pain patients finally began to obtain better treatment through opioid therapy, the media began to run story after story about the rise in opioid prescribing and the increase in the numbers of people addicted to opioids
However, more recently, cheap heroin has flooded illegal drug markets. And consequently, those engaged in the war on pain patients claim that opioid prescribing is leading to more heroin use.
We are witnessing the reverse of what happened twenty years ago, when addicts switched from more expensive heroin to cheaper OxyContin.
Ms. Reynolds also spoke of her experience that deaths were frequently blamed on the presence of opioids in the system of the deceased, even though the person died of a disease. This clearly belies a prejudice with grave consequences for pain patients.
Ms. Reynolds also referred to the painfully obvious fact that physicians as well as the public at large do not believe in something they can’t see or quantify: namely pain. When she complained of pain after brain surgery, her surgeon dismissed her — saying she shouldn’t be in pain at that point.
Her surgeon was basing his opinion on “experience” without taking into account Ms. Reynold’s lived experience.
These prejudices have real, debilitating consequences.
Untold numbers of people with pain suffer stupidly due to lack of education for health care providers, biased science and commentary, and misguided government crackdowns that make viable pain treatment for millions of us a living nightmare.
Ms. Reynolds believes, as I do, that it is imperative for those of us living with pain to tell our stories publicly to offset the ignorance, arrogance and prejudice that seems to rule the market place.
Drug diversion in healthcare settings is more common than medical professionals think, according to a new report from the Centers for Disease Control and Prevention. In addition, the diversion of controlled substances can result in harm to the patients.