Pain

I hate pain.

I Live with it every day.  I severely injured my back in the Army more than 20 years ago, and while I recovered easily in my 20′s, now that I’m in my 40′s, it has come back to haunt me.  I’ve gone to Chiropractors, massage therapists, and seen more doctors than I can remember.  I’ve gone to the ER a few times over the years, but the hassle of waiting followed by the “we can’t find anything wrong with you except a (insert complicated medical term) and an elevated (insert another complicated blood test) level, so have you tried ibuprofen?”  Apparently, pain doesn’t exist to the ER unless it’s covered in blood.

I’m now under a doctor’s care through the VA, and their “pain clinic” regulates exactly what I take for pain, they question me every month to see if I take everything as prescribed, if I take enough and not too much, and how many I have left when I see them for a refill.  They demand to know exactly how many alcoholic drinks I have every month, and if I am seeing another doctor for pain or for any other reason.  They also monitor my liver enzymes and blood sugar, which is a good thing, and subject me to random drug testing, which is intrusive and insulting.  They also want to know my “pain level” on a scale of 0-10 with zero being no pain and 10 being screaming, “take-me-to-the-ER-right-now” pain.  I have learned that even if I have a good day or a good week, I dare not mention it, or they will immediately go into interrogation mode to see if I “really need” the medication, or if they should reduce the quantity or the dosage.  I have also learned not to tell them how much pain I really feel if I have a pain spike or am flat on my back, because they inevitably think I am lying in order to get “high”, so they consider reducing the quantity or dosage again.  To the VA, I exist as a patient with an injury that warrants a pain level from 0 to 5, so they are willing to prescribe X and no more than that.  After all, it’s not cancer, right?  It can’t hurt that bad…  It doesn’t matter that my average daily pain is a solid 7 with occaisional dips to 5 and spikes to 9.   They don’t want me to get addicted to anything, so they don’t come close to treating the pain.  And I can’t tell them about it because my injury doesn’t warrant stronger meds.

Medical professionals understand pain, and in a lot of ways it is why they exist.  Pain indicates something physiologically wrong, and doctors exist to fix the problem if they can, or at least relieve the pain if they cannot.  They also understand pain killers and the side effects related to using them.  Addiction to pain killers, by people who have pain, has been an ongoing problem.  Drug abuse is another common problem; one that can start with pain and attempts to relieve it, or for other reasons.  Some pain killers have other uses, such as methadone, which is used for breaking heroin addiction.

In the United States, the DEA regulates narcotic pain killers heavily.  They do this for a variety of reasons, not the least of which is abuse of narcotics by many who come in contact with them.  They regulate how much a doctor can prescribe to a patient for a given cause.  Obviously, a broken arm hurts, but it is not the same kind, severity, or duration of pain as cancer, so they don’t over-prescribe heavy pain killers for a broken arm, or under-prescribe pain killers for cancer.  The DEA also regulates how much a given doctor can prescribe in total, even if they are pain specialists that deal with a great number of patients.  If a patient gives away or sells some or all of their medication, their prescriptions can be revoked, and they can be charged under the law.  If a doctor prescribes too much to a patient, or doesn’t monitor how much a patient is using, they can be prevented from writing pain killer prescriptions, and they can also be charged under the law.  Pharmacists are equally regulated, and they need to be aware of how much they order and how much they prescribe.

The penalties must be severe to prevent abuses.  I get that.  I don’t want more people addicted to narcotics any more than addicted to tobacco or alcohol, or gambling, or whatever else people get addicted to.  But addiction to narcotics is treated as if the world is ending, with criminal penalties for all involved, from the addict to the enablers who allowed him to get that way.  Just look at how they treated Rush Limbaugh‘s addiction and his “doctor shopping.”  It was in the headlines and the subject of more news coverage and commentary than all of the alcohol addition cases put together that year, no matter how many people are killed by drunk drivers or children abused by drunk parents.

I don’t get why they would rather have a lot of people in too much pain, that could relieved by a higher dose of narcotics, than a few people addicted and have to deal with the repercussions.  I don’t get why they send high doses of Oxycontin to little old ladies in pain in 6-month batches.  A huge number of those prescriptions end up on the street, because children or caretakers of such people find that it is quite lucrative to sell “hill billy heroin” to dealers, who then get it into the hands of real addicts.  Because those abuses occur, I cannot get the treatment I need.

I hate pain.

Related articles

• Addiction to painkillers hobbles patients (seattletimes.nwsource.com)
• Medicaid Patients Selling Rx Drugs To Dealers: Report (huffingtonpost.com)
• Chronic Pain: OTC or Prescription Medicine? (webmd.com)