We all know the statistics. 8.3 out of every thousand people are addicted, according to CNN, and that number is climbing. Deaths continue to mount, police forces argue about the use of Narcan, Seattle is looking at opening its first safe injection site, and still, people are suffering and new addictions are popping up daily. It’s a terrifying proposition, especially as the population realizes that people it once thought were “just like them” are now living on the street, addicted to heroin.
So what happens?
Well, in large part, people like me happen. Ten days ago, now, I had surgery to remove a foreign body from my chest, just below my collarbone. As luck would have it, it wasn’t cancer, which is a giant mental weight I am no longer carrying. However, the muscle that was sliced through is, shall we say, load-bearing, and I’m having to be pretty creative to keep the simple act of sitting-up from pulling on the stitches.
It’s still painful over a week later. My surgeon sent me home with 5 pain pills, explaining that between how sleepy they make people and all the rest I was going to get, those would be plenty. In some cases, for some people, I assume that would be an absolutely fine amount, as they could take the opioid meds and sleep, then wean onto something like naproxen for general wound soreness.
Thing is, I can’t take an NSAID like ibuprophen for the pain, because I’m already on an anti-inflammatory regimen, and they’re already worried about liver damage. This leaves me with nothing to dull the pain in my shoulder. I also have some extra pain I’m dealing with as the biologic injection I use every two weeks to keep my Ankylosing Spondylitis at bay inhibits healing, and so I haven’t been able to use it for a month in order to prevent infection at the surgery site. So, I’m not just in pain from the surgery, I’m also in pain because of the surgery, and that makes things a little worse.
Here’s my problem. I’m in pain all the time, ALL THE TIME. I have a couple of comorbid conditions that mean I spend a good portion of my days with a cane, a service dog, tinted glasses, rescue medications (or some combination thereof). I take a handful of medication every day to let me get out of bed, stand up straight, see, go to graduate school, teach, and interact with my family. If something gets hurt (a sprain, a pulled muscle, a bad bruise), I don’t have anything I CAN take, because there isn’t anything inbetween the OTC meds like Tylenol and Advil, and opioids.
My current doctor gave me an opioid RX when I was in a car accident in February. I carefully cut them into pieces and used them only until I could stand on my own, and make it through my work day. Then, I kept the remaining five pills as my insurance that should I take a tumble down the stairs, I’d be able to relieve the pain for a night to rest. She’s aware of my diagnoses, and hints, not infrequently, that an opioid regimen might be something I should look at getting started on, so that I don’t live every hour of my life in pain. And she makes a good point. I’d be no more addicted to the pain medication, physically, than I am to the medication I take to prevent so many of my migraines, than I am to the pill that allows me to pee, or my iron pills. Bad things happen when I don’t take them, and I am healthier and more active when I do.
But, she won’t be my doctor forever. In fact, she’s leaving the practice this month, and I have to bother someone else in her clinic and start from scratch. If I was on an opioid regimen and that doctor didn’t like it? Those pills could be gone, and I’d be back to this level of pain, immediately.
Adam Ruins Everything did a phenomenal episode on drugs that I would encourage every adult in America to watch, and then watch again with their t(w)een, because this information has been super useful for my 12-going-on-22 daughter. Here’s the clip specific to this topic. It high-lights the fact that we can, and should, be able to have safer pain killers, but that until then, we need to treat those in pain, and addicts, like suffering patients, not criminals. Doing that for both groups would likely decrease both new addictions and deaths.
Most addicts? They start out as people with an RX for pain. Then, they either are already hooked on the high (not something I enjoy, but being fuzzy-headed is great for some people) or hooked on the not-pain they feel elsewhere. Once they can’t get the pills from their doctor, they either doctor shop, or they turn to the street versions, like heroin. New prescription crackdowns will make this tougher on pain patients, even as vague promises are thrown out about doing something.
Which makes it a really frustrating side-effect of being a chronic pain patient, when you do end up in an ER, urgent care, or strange doctor’s office, even if you’re there for a flu shot or something non-pain related, and everyone who has seen your chart starts eyeing you sideways. You’ve taken opioids before. Maybe you’re drug seeking. Are you trying to score some pills? ::sigh:: This, in turn, means disabled people have another reason not to go to the doctor, which makes our conditions worse without supervision, which causes more pain. The cycle then repeats.
So I avoid opiates like the plague. Not because I know that Percoset makes me itchy and Vicodin gives me the tummy rumbles, but because for the 5 to seven days I am on them, after car accidents or surgery, I am at a typical-person 4 on a pain scale, and I absolutely adore it. I can walk my dog without a cane, go to a movie, head to the grocery store. I can clean my house and spend a night in a sleeping bad while camping. I can live just like anyone else who isn’t disabled.
And you can bet your ass I’d get addicted to that. If it got torn away, I’d be devastated.
Carissa Martos is a teacher, mother, author, ASL interpreter, and disability/LGBTQ activist in Portland. She graduated from UC Berkeley before completing her MS in Education in Oregon. Married for 15 years, she’s raising a teen and a tween. She’s worked in everything from retail and health care to customer service, and her writing can be found at www.BleedingKeystrokesYellowWallpaper.com