Where are the Voices of Pain Patients? | Dr. Jeffrey Fudin | by Dr. Maureen Wilks
It seems that every day there is another news item on either prescription drug overdose deaths or the rise in heroin overdose deaths.
These stories tug at our hearts, the heartbreak of the loss of a vibrant teenager or young adult to prescription drugs and/or heroin. But where are the stories of the pain patients?
Where is the voice of my husband who lived stoically for over twenty years with chronic pain?
He bravely kept moving forward always hoping for the pain to abate. He tried all the treatments, countless treatments over endless years.
Multiple physical therapists, acupuncturists, chiropractic adjustments, massage, herbal remedies, herbal wraps, yoga, meditation or prayer but his pain persisted
He took all the non-narcotic medication prescribed. None helped with the pain but the side effects added insult to his pain; some made him feel like a zombie, not himself. Those I made him, stop. Some made him sick to his stomach, others he listed to the right, and a few made ringing noises in his ears and brain.
One had him sweating so much that by morning his pillow was wet. Many of them left him feeling zoned out, listless and mentally uncomfortable, and all the while the pain continued, poorly managed, becoming its own disease.
Finally a doctor listened to his life story and prescribed opioids, along with physical therapy. Over the following months his pain backed down, and his life was bearable, and he moved back into the world to participate with friends and family; to go for walks and camping trips that had become impossible to bear.
And then we read of research, or lack thereof, concludes that opioids do not work on long term chronic pain.
I think of my husband and all the patients I have met over the past ten years as an advocate for chronic pain patients in New Mexico and I want to scream
“How can you make such broad sweeping statements?
How can you ignore the voices of patients whose lives have been transformed by opioids and have lived with them for many years?
How can you place all chronic pain patients into one simple neat little box, wrap it up and throw away the key for a chance of happiness for intractable chronic pain patients?”
Because this is exactly what the latest guidelines from the CDC will do.
it will be a brave doctor that will prescribe above the guidelines because if anything were to happen to a patient under their care and they were not following the guidelines they will face an uphill battle in the law courts of this country. And they know it, and so they will cut back, and patients will be abandoned.
The thrust of all the current research is to come up with as many reasons not to prescribe while all the time avoiding the number one reason to prescribe, which is to manage pain.
Every drug on the market can have some pretty awful side effects.
My husband experienced many of these first hand taking the non-opioid anti-depressants and anti-convulsants
It is estimated that NSAIDS kill 16,000 patients a year. When my husband’s pain was managed, he applied a testosterone cream, and ate a high fiber diet to keep regular bowel movements
But when his pain medication was abruptly taken away in 2011 pain became the overriding aspect of his life, it impacted our relationship so much more; pain overrode all desires.
Over time, people who take opioids for pain sometimes find that they need to take larger doses to get relief. This is caused by more pain, the cancer getting worse, or medicine tolerance.
When a medication doesn’t give you enough pain relief, your doctor may increase the dose and how often you take it. He or she can also prescribe a stronger drug. Both methods are safe and effective under a doctor’s care.”
Researchers need to recognize that chronic pain encompasses a multitude of diseases, injuries and mental health issues and lumping broad groups together is poor science.
Reducing overdose deaths is not quite as simple as reducing access to prescription drugs.
If it were then there should be a correlation between overdose deaths within a state and the amount of opioids being prescribed. New Mexico ranks number two in overdose deaths but only 22 when it comes to prescribing (1 being lowest, 50 highest).
The hundreds of thousands of chronic pain patients living in America deserve better than what the CDC guidelines propose.