Pain Awareness IS Suicide Prevention

Coincidentally, the month of September is both “Pain Awareness Month” and “Suicide Prevention Month”.

Judging from all the articles I’ve found discussing the link between pain and suicide, the juxtaposition of these two awareness campaigns is a fortuitous coincidence, a chance to raise awareness of the potentially deadly consequences of poor pain control.

Perhaps it can start some necessary conversations about how the withdrawal of opioid pain management could exacerbate suicidal impulses.  

If you were the one with a pain that dogged your every moment of every day, draining your energy, souring your mood, and confusing your thinking, how would you feel if the most effective medication was withheld because some other people overdose on it?

How would you feel if your driver’s license were revoked because so many people are killed in traffic accidents? If you were no longer allowed to purchase alcohol because some people become alcoholics? At least these changes wouldn’t make life unbearable.

Is it morally OK to take away someone’s pain relief because someone else had a problem with it? To demand that someone suffer with incurable pain when a medication that eases it is available?

How would you feel if you were being tortured and the people who have the power to end it just stand by and do nothing?

This is the situation many pain patients find themselves in, losing access to opioids, which are the most effective pain relieving medications available. Their potency is one of the few facts that everyone agrees on, even while arguing against their use, only because no studies have been done on using opioids for over 90 days.

Pain is clearly a medical issue, so it would seem doctors would have the final word on its treatment. But instead, bureaucrats and legislators have stepped in and assumed authority. Even law enforcement now enters into what should be a purely medical decision.

Only a medical doctor, and only one with training and experience in pain management, has the knowledge and experience to decide whether opioids are appropriate for a patient. If you deny me pain relief and you are not a doctor, you are practicing medicine without a license.

For the last 20 years, only opioids have allowed me to remain reasonably functional. They dampen the pain enough so I can participate in life, remain active, and make it worth getting up in the morning to face yet another painful day. This is the opposite of addiction, in which opioids are used to escape from life.

Yet the public discourse makes no distinction between opioids taken for pain relief and opioids taken to “get high”. Those campaigning against opioids are deliberately confusing the issue by conflating medical use and addiction, ignoring the critical difference between the two and painting all pain patients as addicts.

How would you feel if you were seeing a doctor for your diabetes or heart disease, and instead of getting symptom-easing medication, you were accused of drug-seeking for an addiction and sent away to “just deal with it”?

What would you do if you were told these heart or diabetes medications were “bad for you” (as they often realistically are) and that you should find a way to mentally override your body’s symptoms? How could you explain that the perceived “badness” of these medications was trivial by comparison to the benefits you reap by taking them?

This is what pain patients are facing, and it creates a sense of hopeless helplessness, one of the main precursors to suicide. How can we, who are facing lifelong and often increasing pain, view this callously anti-opioid attitude as anything else but a refusal to make our lives bearable, or even tolerable?

It seems that society as a whole (at least those not suffering from chronic pain) has turned it’s back on us. Any hope of relief is being systematically shut down from all directions, leaving us to suffer helplessly without recourse, making the quest for effective pain relief hopeless.

We are left to decide only whether we want to live with progressively more destructive pain or not live at all. Our voices are drowned out by the deeper market forces driving the campaign against opioids.

The media stories feeding addiction fears are getting more viewers, the labeling of pain patients as addicts is driving the “recovery industry”, and new companies are springing up every day to provide patient testing and monitoring. All these businesses wildly exaggerate the addiction and overdose rates using questionable and deliberately misinterpreted data.

The government has stepped in with the same kind of “drug war” propaganda as it did with marijuana in the 60’s (see “Reefer Madness“) and it looks like our society is falling for it again. As they say: “Fool me once, shame on you; fool me twice, shame on me.”

How can we pain patients hope to fight the powers of the government and all the money being generated by the campaign to curb opioid use? We are being pushed ever farther into a state of helplessness and hopelessness with no escape… except one.

I can only hope that others too will notice how closely intertwined these issues are during this month of simultaneous pain and suicide awareness campaigns. Perhaps what’s needed is another awareness campaign:

Effective Pain Relief = Suicide Prevention