Why People in Pain Need An Opioid Safety Net

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On paper, I would seem to be a naturally supporter of our national effort to transition chronic pain patients off their opioid medications.

Although I’ve had chronic pain for close to 15 years, I’ve never relied upon opioids to relieve it. In fact, I try to avoid them entirely because they make me sick. I know from experience opioids are often overprescribed and have seen firsthand, (for some people) they can be addictive and dangerous.

However, I’ve ALSO seen firsthand how hard it is to people to recover from chronic pain without them, (or when their access to them is tapered off too quickly or suddenly cut off entirely.) From my perspective within the chronic pain community, the only result I’ve seen from our country’s current mad dash to “solve the opioid epidemic” is depression, frustration and suicide.

Beware of sharks.

Right now people in pain are like the characters Brody and Hooper in the movie JAWS.

In the final scene of the movie after the shark dies, (er…spoiler alert?) the two men snag some nearby barrels in the water and start swimming home. The audience is supposed to feel comforted by this ending, but when you really think about it, it’s anything but…

· Aren’t these guys exhausted and without any food or water?

· Aren’t they now swimming through water strewn with chum? Won’t that just attract more sharks?

· Aren’t these guys far from land? Do they even know in which direction they should be swimming?

Reducing the amount of opioids to which pain patients have access, without ALSO increasing other resources to help them manage their pain, puts more than 100 million people in the very same position as Brody and Hooper.

Like our JAWS heros, people in pain have also been battling a dangerous beast for very a long time and they too are tired, vulnerable, and lost. However, instead of rallying to support them we’re dismantling their life boats in front of their eyes.

Perhaps organizations like the CDC, APHA, HHS and insurance providers assume there are plenty of barrels floating around in the water to which these people can cling. Maybe they assume all of these people instinctively know how to find their way back to shore.

Those assumptions are wrong.

Not a quality barrel in sight.

Our current healthcare system in the US is woefully inadequate in helping people manage the biological, psychological and sociological components of their chronic pain without any opioids. Even finding a doctor is an arduous journey. There are only 3,000–4,000 pain specialists in the US.

Pain clinics which DO holistically address chronic pain are rare. While there were more than 1,000 such clinics in 1995, as a result of opioids being introduced into the marketplace, that number has been reduced to just 150 today.

Medical marijuana — a logical replacement for opioids — has proved to be challenging to obtain. Even in states where it is legal, most doctors refuse to prescribe it and insurance companies won’t cover it, leaving it an option only for those who can afford, (financially and figuratively) to jump through the administrative hoops to get it.

But it’s worth the extra effort because we’re saving lives, right?

Not necessarily. According to the US’s National Pain Strategy, “While all patients who are on opioid therapy for chronic pain are at risk for opioid use disorder, limited recent studies have shown that most (74–96%) of these patients use their prescriptions without suffering from opioid addiction.”

Yes, I’m proof that people CAN overcome these hurdles and still recover from chronic pain without the help of opioids. But I am also a strategic planner by trade who had a slew of resources to support me. Even with those factors on my side, I still found the process so complex to project manage I needed to write a book in order to adequately explain it to others.

It’s time to think bigger

Which brings me back to all of those people in pain treading water right now. Instead of blowing up their lifeboats, wouldn’t it make more sense to give them the resources they need to swim?

We need to broaden our focus and work on solving the chronic pain epidemic, proactively addressing the rising incidence of it in the US and around the world. (Estimates suggest 20% of adults suffer from pain globally and 10% are newly diagnosed with chronic pain each year.) Only then will we have a hope of solving the opioid one.

We need to change how we both prevent and treat chronic pain.

We need to train more doctors to specialize in it.

We need insurance companies to cover more types of providers, procedures, and medications to help us manage it.

We need to research more ideas for treating it, (particularly when the pain occurs alongside other chronic illnesses or conditions.)

We need public education to reduce the stigma surrounding it.

It’s time to stop taking aim at the biggest shark in the water and only talking about how to destroy “the beast” that is opioid/opiate addiction.

There is an ocean of other problems surrounding the pain community right now, and if our country doesn’t start addressing those issues too, people are going to start to drown.

Interested in this topic? Please follow me on Medium to read more posts about chronic pain and my new book, Chronic Pain Recovery: A Practical Guide to Putting Your Life Back Together After Everything Has Fallen Apart, now available on Amazon, Barnes and Noble, iBooks, Google Play and Kobo.
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