Even Doctors Can Be Victims of Opiate Addiction
Here is how I overcame postoperative addiction to OxyContin.
I was addicted to OxyContin. It took about six weeks to feel it: the day was not alright without that drug, even a tiny dose of that drug. My pain from the previous Month’s neurosurgery had subsided, and I was progressing along with my physical therapy routines. But I recognized the addiction.
I needed that drug.
Some mornings, before my daily dose, I felt not quite right. At other times, I awoke with a headache that persisted despite drinking several mugs of strong coffee. With my dose of the little white pill, even half of the pill, I felt better somehow — lighter. It was a startling recognition. My mental outlook was affected by a tiny daily dose of one or two milligrams of OxyContin. This was the result of my having taken that medication nonstop for six weeks.
Three months prior, I injured my back, endured the most severe pain I have ever felt and was diagnosed with a ruptured vertebral disc at L4-L5 with a pinched spinal nerve. The injury caused my left leg and lower back to feel like they were on fire, and I could not walk.
When it was clear that injections with cortisone and anesthetics made no difference, this eager, young neurosurgeon informed me that surgery was necessary. I saw my anatomy laid out in vivid colors on his realistic computer program. He pointed to the sites for the surgery to remove the disc and its fragments, replace it with a titanium cage and bone graft and create a spinal fusion with two titanium plates and four screws to create a platform keeping the spinal nerve unimpeded. But I digress.
My neurosurgery went well, but afterward, everything hurt like hell. IV pain meds were given for only two days, and I was switched to oral OxyContin more quickly than I expected.
Not surprisingly, I needed more than the average patient to control my pain. (Many nurses and anesthesiologists are familiar with the lower pain threshold tolerated by redheads.) I learned to log roll to get in and out of bed, use assistive devices to go to the bathroom, and cruise the halls.
OxyContin is a great pain killer; it literally makes the pain go away for a few hours. I had lots of “breakthrough” pain between doses and left the hospital on 60 mg per day of OxyContin. At home, my physician-husband and nurse-daughter created a MAR, a written medication administration record, at my beside.
For days they dished out the meds I needed to sleep, move, and rest. Every few days, they decreased my dose of OxyContin. By four weeks after surgery, I was on a total of 20 mg each day, spread out as 5 mg every six hours.
The neurosurgery NP said, “You may only have one more prescription, enough for one more month.” After that, no more. I thought I could handle that, but I was wrong.
One day I tried to cut the dose down by half and had a huge backslide, crying in pain and frustration without my drug. My good friend, the pharmacologist, asked me how we weaned our preemies off of narcotics, and I told him that we generally cut the dose by 15% every other day, provided they tolerated the wean. He asked me why I was not doing the same thing with my own weaning. Good question.
My husband and I kept up the MAR, and I continued to split my little white pills and spread them out and down as meticulously as I could. Every mg and every dose was recorded.
At six weeks after surgery, I noticed the decreasing doses easily. Every twelve-hour dosing seemed cruel to my psyche. By seven weeks out, I was on a low dose every twenty-four hours.
Entering week eight filled me with fear and dread. I was not ready to let this drug go.
I took slivers of the OxyContin pill each morning. The day after my last pill, I was miserable and foggy, with a headache brewing. This headache persisted for twenty-four hours while I called for more meds but was refused. I called other doctors and begged for more of this drug and was repeatedly told no. I laid in my darkened room and endured the worst headache of my life.
Two days later, I was off OxyContin.
My recollection of this experience with addiction to OxyContin says that I, a critical-care physician married to a physician, endured major effort and angst weaning off of OxyContin. I cannot believe that an average lay (non-medical) person would be able to do this.
I have read recently that narcotic drug addiction is on the rise in the U.S. Deaths from overdoses are at an all-time high. Most heroin addiction begins with a legitimate narcotic pain medication prescription, followed by quick addiction. How can we, as a society, think that ordinary people should be able to get themselves off this addictive drug?
Originally published at https://susanlandersmd.com on May 16, 2021.