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Friday, July 17, 2009

The War on Pain Management

So Michael Jackson kicks the bucket....presumeably due to prescription pain medicine abuse...and suddenly the old Crusade against pain management is roaring, once again...
I suffer from chronic pain...
Hip/anlke/knee are the main culprits, due to catastrophic injuries, near 20 years ago...
But I also have widespread, peripheral pain...every bone I've ever fractured...back, due to compensating for the other injuries..(Lift w/ yer knees...unless yer knees are hopelessly marred.)
When the weather changes, especially in the Fall and Spring,..or when I overdo some necessary activity...or, sometimes, for no apparent reason at all...I'm knocked flat by severe, debilitating pain.
Hurts to lie in bed.
I took all kind of NSAIDs for the first 15 years...till I connected them with the heartburn and other digestive difficulties.
This caused me to do a heap of research...find out all about the drugs I was taking.
Turns out, that Tylenol and other NSAIDs are some of the most dangerous drugs available.
There are, it seems, hundreds of varieties of NSAIDs readily available...the stronger they are, the more scary side effects are associated with them.
"Sudden Death", "Catastrophic, lower GI bleeds, without warning.." etc...
I realise, being terminally skeptical, that these side effects are "merely" statistical...coming out of clinical trials...
Perhaps .01% of the sample had these horrible symptoms...
Still.
Too, these drugs are well known Liver Killers.
Read the label...read the PDR...
I began searching for alternatives...
Alcohol works...lol.
However it, too, is a liver killer...and has other, undesireable, side effects...i.e. Drunkenness.
"Golly", I thought..."there sure aren't many choices"
Then I looked past the propaganda...and found the Panacaea.
Opiates!
Specifically, Vicodin.
Now, in the US, Hydrocodone only comes with the equivalent of an Extra Strength Tylenol attached to it.
This is, ostensibly, to prevent abuse.
Turns out that opiates, when closely monitored and managed, are some of the safest drugs on the planet.
The main side effects, constipation and addiction, are avoidable with careful management...
And the scary stuff associated with them, like CNS Depression, Coma and Death are really easily avoided...(Just don't take a shitload of them.)
So I acquired a Vicodin presription from my Doctor.
For more than a year, I've been taking 1/3 of the maximum dose allowed on the presciption...and only when the pain becomes unbearable...or preemptively, when I know I must walk the pasture to find lost baby goats, or whatever...
With a healthy respect for this drug, I've managed to cut down on drinking (the Tylenol portion made this necessary as much as the hydrocodone did...)...Ilve slept better...and ,overall, my quality of life has improved.
I still hurt all the damned time, and I'm sometimes knocked flat by pain,and I can't handle any of the jobs to be found out here, but things are mostly a lot better.
I have guarded against addiction...and, even more, guarded against developing tolerance for this drug.
The last thing I want is for hydrocodone to stop being effective.
The next steps up the ladder are things like Oxycontin...I don't want to go there.

Well, Michael Jackson died...and the issue of prescription pain killers is all over the news...
Stories about folks who "doctor shop"...folks who take a month's worth of Vicodin per day...etc.
Nowhere have I seen an examination of causes...why are these people doing this?
And even more frustrating, nowhere have I seen an examination of simple methods of preventing this kind of behaviour....i.e. Some kind of registry, that can be checked by a doctor to determine if the person seeking these drugs is a "shopper".
Now, my Doctor (who I have a great relationship with) has apparently caught the bug.
Is it media influence?A reminder from the DEA?
I've been cut off from the only medicine I've found that 1.works 2.doesn't mess up my belly and 3. doesn't scare the shit out of me when I read the info the Pharmacist icludes with every refill.
I've been reserving my last 3 pills (I only take a half at a time) for 4 days...Figger I might need them when the pain gets too terrible...
I haven;t licked the pill bottle...haven't sought out illicit supplies...I have felt no withdrawal symptoms, save increased pain...
I'm even willing to suffer for a month in order to prove that I'm not an addict...like they show on TV...

I hope this tactic works...Fall is approaching...
Along with Hurricane season...(I felt Katrina and Wilma like they were in my room, from 3000+ miles away..)

This whole thing is more a result of politics, and a Puritan outlook on suffering (Suffering is Good(!!?!)), than it is of science.
The Drug War...(Pot, by the way, helps a little, too...esp. for the depression that inevitably comes from not being able to fish or fuck or play with my kids...)
The Drug War IS a War on People.
Instead of taking a rational approach to mitigating the undesirable effects of many of these drugs, we demonise them...and anyone who uses them...and anyone who is thought likely to use them.(Hippies)
Consider pot, for a moment...
The Party Line of the Drug Warriors, for 80 years, has been that Pot is as bad or worse than Heroin...that it makes ya' violent and crazy...that it is a "Gateway Drug"(ie if you smoke Pot, you will ,as day follows night,end up shooting Heroin)...
All of this has been proven, scientifically and repeatedly, to be wholly untrue.
Information and studies (conducted, in many cases, by our own Government) is widely available...yet the lies persist.
The Mythology endures...and , again, trumps Objective Reality.
I can take $10,000 and clean out a liquor store...take it all home, and drink myself to death...and it's perfectly legal.
But heaven forbid I smoke a joint in the yard...or manage my pain with quasi-legal substances.

Being a long-haired hippie, I have been chased by cops my whole life...
Since i've been taking Vicodin, I must go to the only Pharmacy where the folks who work there actually know me...anywhere where I'm anonymous, I can't get the presciption filled due to my age and appearance..
Seems I fit some kind of "Profile"...which is of course rediculous and hopelessly outdated.
All the drug dealers I've known in my life have been clean cut Frat Boys...
They have NOT been long haired, bearded hippies in camo shorts, driving a garish, spray painted pick up truck,an walking with a stick and a noticeable limp...
Mythology trumps Reality.

I could, I guess, grow Opium...chew the sap, or whatever...
But I don't want to...
What I want is to take a relatively safe medication, with few side effects, and under doctor's supervision...in order to have a reasonable facsimile of a Normal Life.
As it stands, I can't have the surgeries that would (hopefully) take care of the worst pain...and I can't have the medicine I need to mitigate that pain.

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