I’ve been thinking about this post for awhile. I’ve been thinking about whether or not I’m brave enough to write it. And once it’s written, am I brave enough to post it? Because it has to do with a stigma that is damaging to the patients it affects. And it has to do with opioids.
Hi, my name is Laura. I have chronic pain. And I use opioids to control that pain.
I wonder how many of you just had the word “addict” float through your heads. Or “liar.” Or “drug-seeker.” Don’t worry, I’ve heard it. Let’s review this excerpt from my post How to Save a Life.
Then there was a week in April when everything got messed up. For reasons that I still don’t know, (likely a glitch in the computer system) my doctor never got the message that I needed a refill on my medication. So when I had allowed several days to pass and then called the office, expecting to be told the paper prescription was ready for me to pick up, the office staff had no idea what I was talking about. It took two more days and speaking to three more people to get the message to my physician that I was by this point completely out of pain medication (and I had put the request in early to prevent this). My pain had skyrocketed almost to the point of requiring a visit to the emergency room. Upon talking to a nurse practitioner about the problem, she said that the refill may have been rejected by my physician because pain meds can only be filled every 30 days.
*clears throat, throws on white lab coat* Listen lady, if you’re going to make up something, don’t make it up to a practicing pharmacist who knows drug laws better than you do, because that “law” you just told me about does not exist. A fill of a controlled prescription is based on not being permitted to write more than a 30 day supply, so you should be able to do the math and see that my prescription is for a 15 day supply and it has actually been 20 days since my last fill. Get it right. Then, when she realized I had called her out on lying, her immediate response was, “Well, some physicians might deny refills to patients displaying addictive behaviors.”
Let me be clear about something. My doctor, the person who prescribes my opioid pain medication, has never made any such accusations towards me. In fact, it was her who called me a few weeks after this incident saying she wanted to see me in her office the next week to discuss my pain control. Normally, most people would think she was going to cut me off since perhaps she thought I was taking too much Percocet, given my need for frequent (but appropriate) refills. But no, my doctor, who knows my care better than anyone else, called me to her office to help me by suggesting I go on a long-acting opioid. She saw that what we were doing wasn’t working and I needed better control.
I see my doctor every three months so we can assess my pain management. She appropriately checks our state’s controlled substances reporting system routinely, which keeps track of every controlled substance prescription filled by every patient everywhere in the state. We dot every i and cross every t to ensure everything is medically appropriate and legal.
But that nurse practitioner fell into the large group of people out there who think that any patient who takes opioids for any reason is a drug addict. She didn’t know me. She was just returning a phone call. She knew nothing about my care or why I was even on pain medication in the first place. But she made the assumption because that’s what people do to people on opioids. We are stigmatized because of those individuals who abuse the drugs we need to function.
And I’m not exaggerating about needing them to function. While on pain medications, people with chronic pain aren’t lying around snowed. We’re getting things done. We’re cleaning the house. We’re going to work. Heck, we might even be going to the gym for a gentle workout. Does that seem hypocritical? No, it shouldn’t. If we didn’t have pain medications, we would be in bed, unable to function. Unable to work. Unable to care for our families. I’ve been there.
So if we do take pain medications and are functional people, we are addicts. If we don’t take pain medications and are nonfunctional people, we are lazy hypochondriacs. Do you see the problem here?
Tell me, when you non-chronic pain people have pain, what do you do? Don’t you want relief? So you take something. When a chronic pain patient has pain, it’s intense. We want relief too. Don’t you think we’ve tried OTC pain meds? They don’t work with chronic pain. If they did, you can bet we’d be taking them! So we take the medications that do work, which are often opioids. I’m not selling them. I’m not getting high off them (taking too much makes you feel like puking, not flying!)
And just in case you’re wondering, I’m not even on long-acting opioids anymore. I had surgery to fix the problem that had been causing my pain for over a year and am now doing well. Since I’m still post-op, I need an occasional few Percocet on a bad day, but I’m nearly through with that too. Does that sound like addiction to you?
If chronic pain patients are addicted to anything, it’s to not being in pain. And I don’t see anything wrong with that.
Stop the stigma. Just let us be normal people. Wouldn’t you want that for yourself if it were you?