The Electric Briar In My Neck
On December 5, 2016, a college student running late for an exam rear-ended me as I was stopped in a turn lane waiting for the light to change. The accident left me with an inflamed nerve between my C5 and C6 vertebrae. I’ve tried various treatments, but nothing works. My doctors tell me that I’ll almost certainly have this with me for the rest of my life.
The pain is not disabling, but it’s almost always there, and ordinary pain medication does nothing for the problem. Sometimes — like this morning — it’s significantly worse than other times. When I woke up this morning, it felt like there was an electric briar in my neck that had heated up enough to toast bread.
Fortunately, I have a prescription for hydrocodone. I took one of those pills, and it brought the pain under control. Now I can do my work, and get on with my day. When I tell you that I thank God for this medication, I mean it literally. It makes my work possible when I’m in pain.
I’m really fortunate in that this medication does not make me feel high. It stops the pain, but that’s it. Because I’m so anxious about addiction, I’ve been talking with my doctors about it. They tell me that not everybody who uses these medications are susceptible to addiction. In that regard, I’m one of the lucky ones.
Several months into my treatment, I was talking to a nurse-practitioner about addiction, and she was expressing intense anger at drug companies and doctors for the opioid crisis, the effects of which she sees firsthand when she works the ER. I told her that I am very vigilant not to turn into one of those people. She said, “I think you’re fine. If you were the kind to be addicted, you’d be there already.”
That eases my mind somewhat, but still, I keep a running dialogue with my doctor about the painkillers, just to be on the safe side. I probably drive him crazy, but I’d rather be safe than sorry.
I tell you all this because authorities, in an effort to crack down on prescription opioid abuse, are hurting people who aren’t a threat. According to USA Today, the strict new approach has affected innocent sufferers from chronic pain:
That attitude has led some doctors whose patients have had no problems with opioid prescriptions to back away from prescribing them. Schatman said there’s a big difference between depending on opioids to survive and becoming addicted to them.
Cathy Mitchell, a disabled registered nurse, suffers from a long list of injuries and diseases, including osteoarthritis, post-major lumbar surgery for ruptured discs, cervical scoliosis and bilateral carpal tunnel syndrome.
Disabled since 2013, she said only opioids provide the pain relief that allows her to “function daily.”
She has to go to a pain clinic every 28 days and her primary care doctor every three months. After 10 years of being treated for pain and anxiety “without causing any problems,” Mitchell can no longer be treated for both.
Making matters worse for what’s estimated to be millions of patients, the Centers for Medicare and Medicaid Services plans to drop coverage of opioid medications above a certain dosage starting next year.
Elsewhere at the Department of Health and Human Services, the FDA’s plans include encouraging medical device development for pain and hosting a drug development meeting July 9 that focuses on how hard it is for patients with chronic pain to get treatment and what solutions exist.
“The reality is that the opioid drugs work for certain patients, and there are certain situations where the opioids are the only drugs that work for those patients,” FDA Commissioner Scott Gottlieb said.
Again, my chronic pain is nowhere near what this poor woman is suffering, but it’s enough to interfere with my daily life on most days, even when the pain is not as acute as it is (or was) this morning. I was talking a while ago to a college professor friend who suffers from chronic pain acquired when a drunk driver smashed into his car. He told me that he cannot function professionally (that is, he can’t teach class) without using hydrocodone, and that it makes him angry that addicts and abusers put people like him and me in the position of feeling shame over having to use medication that we need to function.
Totally agree. I would love never to have to use this stuff again, or to find a non-opioid painkiller that actually kills this particular pain. But until that day arrives, I’m so, so grateful that it’s available, and I’m grateful that for whatever physiological reason, my body is resistant to addiction.
Clearly the system we have now is not working. A distant cousin of mine died earlier this year from old age, but in her final year, her caretakers discovered that she had become severely dependent on oxycodone prescribed for pain from a hip replacement years earlier, and had even manipulated the system somehow to get a double dose. She really did need pain meds for her condition, but she abused the system. When her caretaker got wise to what my elderly cousin was doing, she looked into the pain clinic system of which my cousin was a part, and was appalled at what a factory it was. Something has to change.
On the other hand, how can address those problems while minimizing the chance of things like what happened to Meredith Lawrence’s husband occurring? Lawrence writes:
If you or somebody you love have not been directly impacted by long-term chronic pain, then you are very fortunate. Keep in mind that we are all just one car accident away from that condition.
A car accident in the early 1980s is the reason my husband, Jay, developed chronic pain. The backlash against opiate addiction and the ill-conceived U.S. Centers for Disease Control response to that is what caused him to end his life.
Jay was young and strong enough not immediately to need pain medications to manage his back injury. He dealt with his pain until his condition degenerated, and he was forced to have three back surgeries in 2007 and 2008. It was at this point that he was started on low dosages of pain medications. As time went on, he developed some tolerance to these medications.
He worked with a doctor to make sure that he was on the lowest possible dosage that would allow him to maintain some quality of life. He also allowed them to do any other procedure they thought necessary beyond just prescribing medications. This included implanting a device in his side that delivered a constant dosage of medication.
The back injury did not allow him to work, and it severely limited him in many ways. A good day was as simple as being able to take our dogs for a walk or to go to the grocery store with me. A bad day would leave my strong, fiercely-independent husband in so much pain he would sit in his chair and sob.
And then the CDC came out with its guidelines:
My introduction to these guidelines came when Comprehensive Pain Specialists told my husband they were cutting his medications by 75 percent. The reason that we were given was that eventually the guidelines might become law. The last thing the doctor said to my husband was “My patients’ quality of life is not worth risking my practice or my license over.”
It did not matter to them that my husband was not abusing his medication or that he had been their patient for over five years. It did not matter how drastically they were reducing his quality of life.
Rather than face the unbearable pain that losing his medication would cause him, my husband chose to end his life, and I supported that decision.
What concerns me most about the closing of these pain clinics can be summed up in what my husband told me after they reduced his medications. He told me he felt like he had been given three choices. He could turn to illegal drugs, he could suffer unimaginable pain or he could end his life.
My God. That poor man was in so much pain that even his wife supported his decision to kill himself. Think of it!
I hasten to add that I’m not remotely in that situation, but the “we are all just one car accident away from that condition” point really came home hard to me as a result of what was a minor fender-bender. It just so happened that I had my head turned in the right way for that injury to happen when the college student rammed us from behind. There has not been a single day since then that I haven’t felt pain in my neck from that accident, minor though it was.
When you think about the opioid crisis, you naturally think about the lives ruined by addiction to prescription painkillers. But you should also think about the lives made possible by the existence of these medications. Your life — I mean your daily life of work, shopping, recreation, and so forth — could be seriously affected by someone crashing into you on your way home from work today. There’s nothing like having a hot electric briar embedded in your neck to make you grateful for pharmaceutical relief.