The time has come for someone to speak up for the millions of Americans who suffer with daily chronic pain and who do not abuse the drugs that they take to try to maintain a semblance of a normal life. This is not meant to pass judgment on those who have to wrestle with the demons of addiction, but to shed light on the other side of the story.
According to an August 2015 study by the National Institutes of Health, 50 million adult Americans have either severe or chronic pain. That's a lot of people and that means that many of those people are trying something to alleviate their suffering.
Not everyone who has chronic pain reaches for the pill bottle as a first line of treatment. Many people try a host of other types of treatment if they are able to be patient enough to see results. Acupuncture, yoga, meditation, all kinds of mindfulness therapies, as well as many other treatments that fall under the category of complementary and alternative, offer relief to many people.
But pain is pain and that means that no matter how hard one may try to avoid pills they will probably resort to some sort of medication for relief. Contrary to what the popular press might have one believe, many chronic pain sufferers have tried milder analgesics first. Sometimes they work and there are times when people do not have to look for something stronger, or at least do not make the leap to opiates. That may be the case when they use non-opiate analgesics in conjunction with alternative therapies.
All medications have side effects and some of the most life-threatening may occur with use of some of the milder analgesics such as the non-steroidal anti-inflammatories (NSAIDS). In high doses NSAIDS can relieve many types of pain. The problem is that over time one may end up with damage to the gastrointestinal tract or kidneys, and that is not worth the relief they might offer.
Then there are the newly labeled medication pariahs; evil opiates. Opiates have side effects as well. Over time opiates tend to re-program the nervous system and that is something that a chronic pain sufferer has to consider. Constipation is also a problem with opiates but it is something that can be dealt with effectively.
Because opiates tend to create a feeling of euphoria along with pain relief they are very seductive drugs. When a chronic pain sufferer takes opiates over the course of years the euphoria piece fades away but the pain control piece remains. There are millions of people who take medications such as Vicodin, Morphine and Dilaudid and manage to lead normal lives because they are mindful of not using the drug to get high but to control pain.
It is possible for someone with chronic pain to continue to use opiates for years without having to increase the dosage significantly. They have to realize that the drugs will slowly become less effective over time and that there will be a temptation to increase the dose. Once they come to terms with these issues they can then come to terms with their own pain.
Coming to terms with pain means learning to accept a certain level of pain. That level should not hinder daily activities but it will be there all of the time. Another thing that chronic pain sufferers need to come to terms with is the concept that not all problems can be fixed. Sure, it's good to get second and third opinions and try surgical options, but in the end, there will always be people for whom none of the conventional treatments will offer relief.
There are therapists and clinics that specialize in dealing with chronic pain. We even have such a facility here at the Brattleboro Retreat that offers non-medication options for pain relief. Many people who go to other so-called pain clinics find that they have not lived up to expectations because the level of research dedicated to pain relief is so meager. It is an area that needs a lot more research.
Given the big numbers of pain sufferers in the world one might think the drug companies would see a lot of potential to make big bucks by developing some better pain relief medications. Maybe they are in the pipeline.
For now, the best we can do is to try to find ways to treat and live with chronic pain that do not make us become social pariahs. I fear that the current policies that deal with opiate prescribing and treatment protocols may prove to make it even more difficult for the non-addicted population of people with chronic pain to get the kind of care they need.
Richard Davis is a registered nurse. He writes from Guilford and welcomes comments at firstname.lastname@example.org.