This post began when I posted a “Thought” on The Mighty (a pop-up will prompt you to sign in, but there is a small link at the bottom allows you to bypass registration and go on to the site,) that included a graphic pertaining to advocating for chronic pain patients (see to the right or below.) A reader commented asking to explain more of the problem since they don’t live in the United States. That reply turned into 834 words, so I decided it was worth a post.
First, I want to be completely clear on something- I do not currently take any opiate pain medication on a regular basis. I only allow it to be given in acute situations that are too intense for me to handle, and only until I can manage to tolerate the pain. When my chronic conditions started, I chased pain relief for quite some time, and the doctors were very willing to give them to me. They gave me more than they should have, and eventually I realized that I was creating a future problem for myself by using those medications now, because I will need them much more as my conditions progress.
At the time, I was only in my late 20’s, and started imagining what it’s going to be like if I make it to 60. By using pain meds all the time now to get relief, I could very well be denying myself the ability to get relief from them when it’s even worse. So, I use a variety of different alternative methods of pain control to make it tolerable. It meant giving up any traditional career, and making huge adjustments to my life since I can’t function well, but it’s the only way to ensure they will be able to help later.
The Addiction Crisis vs. The Pain Management Crisis
We have a huge problem with substance abuse in the US, but let me be clear- REAL chronic pain patients did NOT cause, or add to the problem in any way, and our pain management crisis should be an entirely separate issue from the addiction crisis. Unfortunately, it often is all lumped together, creating confusion for people outside of either crisis, making them believe it’s all the same thing.
The substance abuse (addiction crisis) problem has been around for a long time, but has gotten exponentially worse in the past 20 years. Many people may say a different time-frame, but I can trace the current major problems back throughout the past couple of decades. Street drugs have been a thing for a long time, but the current crisis got bad when the medical industry got involved- not chronic pain patients– but the pharmaceutical companies and doctors.
The current addiction crisis has affected small towns and huge cities, and all ages and demographics. I researched the actual statistics to add to this post, but the problem I ran into was that none of what I read is entirely accurate, so I refuse to use those numbers- even from sources I would usually deem credible. I’ve seen too much of this crisis first-hand to be able to accept both those numbers AND the manner in which they are presented, because it tells me they were gathering the wrong data in the first place, just like they are focusing on all the wrong aspects of how to fix the problem. If you want to read their “statistics,” you can find some of them by visiting the National Institute on Drug Abuse.
What Led To the Current Addiction Problem
The real addiction crisis we have now started when pharmaceutical companies realized that they could basically be “legal drug dealers” and make mad money off their pills by having doctors push them on everyone they could, and by making deals with street dealers to sell them pills straight from the manufacturing plants (basically.)
It turns out that pharmaceutical companies sent millions of pills to tiny towns all over West Virginia (where we live). Way more than could ever be therapeutically necessary for the number of citizens there.
There were “patients” that weren’t legitimate patients at all, and there were patients who really did have chronic pain, that were prescribed to a higher dose, more frequently than needed, because the doctors & pharmacies got a cut of each prescription. I mean, they probably don’t want to put it that way, but that’s what it all amounts to. The more prescriptions they wrote or filled, the more they benefited financially. That’s the bottom line, and what led to doctors prescribing the drugs when they weren’t needed.
They created addictions in people who never should have been given the medication, prescribed pills to people knowing that they were selling the drugs, and pushed more pain medication than medically necessary onto chronic pain patients- creating a scenario where their tolerance progressed at a much faster rate than it would have if they had been started at the lowest level possible and gradually stepped up as needed.
When It Went Really Wrong
Then, as it started getting out of control, and society noticed there was a problem, the pharmaceutical industry attempted to curb it by changing the structural make-up of some of the strongest pain medications to make them harder to abuse. This was the absolute worst move they could have made because people who want to abuse drugs will do so no matter what. If you take away their current drug of choice- they’ll just find another. If you don’t understand that fact, you are missing a huge piece of the puzzle.
All they did with that move was hurt the chronic pain patients who desperately needed those drugs to work well (because the new pills weren’t as effective when swallowed, either,) and created an opening for fentanyl and heroin to slide into the scene full force. The day I saw the news report about them changing the meds and creating new rules to enforce, I told my husband that they just created a nightmare scenario, and within two years, our town got famous for having 26 overdoses in 4 hours. Netflix even made a documentary called HeroinE about our town.
When they took the pills away, it was like open season for street dealers. There were so many people needing to “get well” (what they call it when they need their next dose to keep from being violently ill,) or control pain, that fentanyl and heroin took over within days. Hours really, but most don’t recognize that.
Law enforcement agencies attempt to fix the problem by confiscating drugs and disrupting their flow throughout the country. “Street” drugs and pain medications they find during investigations are taken off the streets, but it’s only a temporary fix until the next dealer sets up shop. It’s a cycle that is never going to allow confiscating drugs to fix the problem, neither will prosecuting anyone, because there is always someone else ready to step in and take their place.
How It’s Affecting the Pain Management Crisis
Now that they’ve realized the problem happened pretty much all over the country, and they created a monster, they’re trying to fix it by making all these laws for pain patients, and so much other nonsense, instead of doing what will really help- finding solutions for the underlying reasons people are abusing the drugs, and creating serious patient education programs for chronic pain patients. This lead to what is now the Pain Management Crisis.
People who aren’t affected by the problem are just sitting back saying things like “With the addiction crisis how it is, doctors have to be able to deny writing pain medicine to keep their liability down,” and a hundred things that all have the same basic theme of “Protect the doctors and medical industry at the cost of everything- even patient care.” There is no way it is better for our health to be in pain constantly than to take medicine designed to give us relief- when used as intended and as sparingly as possible.
When doctors and patients sit down TOGETHER and determine a plan for pain management, and set standards for when dosage or frequency needs to be revisited, pain medication can work miracles for people living with chronic pain. It can be the difference between being able to function as a normal member of society, and having to stay isolated and immobile because the pain won’t allow anything else.
What is happening now is that chronic pain patients are being treated like we caused the addiction crisis. All the laws that have been passed hurt those of us in the pain management crisis far more than they hurt those who are involved in the addiction crisis. The legitimate doctors are so worried they’ll somehow get in trouble for prescribing pain medicine that they are letting their chronic pain patients suffer, and the doctors who are just worried about their liability are worried about getting shut down.
That’s Not How It’s Supposed To Be
See, my problem with all that is the oath they take when they become a medical professional. Instead of taking it seriously, centering everything around improving the quality of, or saving, lives- they worry about what will create the most income, or, in the case of the policies & laws, what protects them from being held liable. I know it’s pretty cheesy to use the “Do no harm” part here, but it’s a valid point. They are supposed to NOT be doing harm. When they allow chronic pain patients to suffer, it’s doing harm to their bodies, minds, and relationships.
Medicine isn’t supposed to be about money, or protecting the doctor- it’s supposed to be about always helping the patient and doing everything in their power to preserve life. Both general society, and many of the medical professionals, have lost sight of that, and we have to show them that they are wrong in how they are looking at the whole situation.
In my view- if they slow down and do their job right as a physician instead of just focusing on seeing as many patients as possible to increase profits- why would they need to worry about their liability? If taken to court, they should be able to show exactly why they made every decision they did, with labs & other test results. As long as they were really doing their job, the evidence should be there to keep them clear, and there are things that can be implemented to help. Require every conversation about pain medication to be recorded so that there is proof of doctors asking the right questions and following therapeutic standards. Those standards also need to be evaluated and adjusted to address the newest proven research, but also to make sure QUALITY OF LIFE is always the priority.
For the REAL chronic pain patients that have medical histories to show why we need pain management, doctors should be doing everything they can to make sure we are being treated properly, and have the best quality of life that modern medicine can offer- despite whatever money is involved or whatever madness is happening- PATIENT CARE, and not their liability, is supposed to be the priority.
Some of the responsibility falls on the courts to evaluate cases fairly and make sure they aren’t allowing frivolous lawsuits to be upheld against medical professionals, but they also have to make sure they aren’t playing the “protect the money” game, and allow the suits to happen when a doctor HAS done wrong. Our sue-happy culture mixed with our love of technicalities helped create that aspect of this problem, and they need to make quite a few changes to the medical malpractice and liability laws in order to make sure patients have an option if a doctor is really doing wrong, while also making sure the doctors who are truly doing their jobs correctly are protected. I DO understand it’s a fine line, and complicated to define, but it can be done in a much better way than we are doing now.
Things Must Change
There needs to be strict guidelines on what is considered real wrong doing, and ways to prevent petty accusations while still giving a way to prosecute those who are practicing medicine irresponsibly. Yes, this is easier for me to talk about than it would be to put into practice, but as has been said many times, usually the things that are right and worthwhile aren’t easy to do. Getting the focus of medicine back to quality of life is the only way to make things better in the medical industry.
They use all these things as excuses because it’s all about money and we desperately need to change it to being about patient care and quality of life- like medicine was intended to be. My goal is to make people see that they wouldn’t tolerate this if it was something THEY needed just to function at even a low level. They should not be lumping pain patients in with those using drugs for other reasons. We should be treated with respect, and as a priority. I’m tired of settling for the excuses of “They’ve made all the new laws.” That’s unacceptable.
FIX the laws.
Educate people, restructure the industry- do things that will actually matter instead of suing pharmaceutical industries and making it to where doctors are “afraid” to prescribe meds. IF THEY ARE BEING PRESCRIBED CORRECTLY- based on what gives the patient the best quality of life- THERE IS NOTHING TO FEAR. Yet, here we are, suffering, because they are apparantly scared and unwilling to do right by us.
We need the help of those who don’t have chronic conditions. We need you to advocate for the government and medical industries to make the necessary changes to give us the opportunity to relieve our suffering and, in some cases, even resume functioning at a level society deems acceptable. Help us fight because it could be you, or someone you love, desperately needing relief for chronic pain one day. Even if it’s not a chronic condition, it’s very possible you will eventually find yourself in front of a doctor who is unwilling to manage your pain from an injury because they are afraid to prescribe them.