In August 1994, I stepped into my office on a Saturday afternoon, intending to finalize a brief due in federal court on Monday. At that time, I was serving as a civil rights attorney in the Justice Department. Just thirty minutes into my work, an intense burning sensation gripped my back, as if my spine were being consumed by acid. Suddenly, my muscles seized, forcing me to collapse to the floor amidst a wave of excruciating pain.
What I didn’t realize then was that this agony would become my constant companion for nearly two decades, rendering me unable to sit, stand, or walk unassisted. I could never have imagined that opioids would eventually play a crucial role in my pain management.
Today, the conversation around opioids is dominated by tragic stories of overdose and addiction. However, we often overlook another reality: opioids are the most potent medications available for severe pain relief. For me, they were nothing short of life-changing.
With proper pain management that included opioids, I transformed from being bedridden and unable to sleep for extended periods to successfully negotiating major settlement agreements and arguing significant cases in federal court. Although I couldn’t sit or stand normally, I adapted, conducting negotiations via video calls and managing cases from a makeshift platform bed. I continued to work and engage with my community.
Sadly, many pain patients today face dire circumstances due to policies aimed at curbing prescription opioid misuse. Long-term, legitimate pain patients now struggle to fill their prescriptions in numerous states imposing strict dosage and supply limits, typically ranging from three to seven days. Even in states allowing exceptions for chronic pain management, insurance companies often deny coverage, further complicating access to necessary care. This has left many patients involuntarily tapered off opioids, even those who have never exhibited signs of misuse, resulting in increased suffering, diminished quality of life, and in some cases, suicide.
Recently, a well-known figure in law enforcement dismissed the concerns of pain patients, suggesting they could simply take over-the-counter pain relievers and rest. This comment highlights a profound misunderstanding of chronic pain conditions, which can severely impact the quality of life. Nearly 50 million Americans suffer from severe or persistent pain, a figure that dwarfs the number of individuals who misuse opioids. Chronic pain is the leading cause of disability in the U.S. and costs the economy hundreds of billions of dollars annually.
It’s crucial to distinguish between using medications to manage a health condition responsibly and misusing substances in ways that lead to dysfunction. Most individuals who take opioids for pain do not abuse them; research indicates that the risk of addiction ranges from 0.07% to 8%. Furthermore, when prescribed with appropriate screening and follow-up care, the likelihood of addiction decreases significantly.
The majority of those who misuse prescription opioids did not obtain them through healthcare channels; they sourced them from friends, family, or illicit markets. Like many pain sufferers, I was initially hesitant to resort to opioids. I explored every possible treatment first.
My pain stemmed from a surgical mishap where nerve plexuses in my spine were severed, leading me to try numerous therapies, including nerve blocks, infusions, physical therapy, acupuncture, and even another surgery. However, nothing alleviated my suffering. Ultimately, treatment with opioids, paired with integrative care, allowed me to maintain a job and a sense of purpose until I eventually found a path to healing. My experience is one rarely shared, highlighting the potential for individuals to take opioids responsibly and discontinue their use without adverse effects when their pain subsides. Unfortunately, such narratives may become increasingly scarce in today’s climate.
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Summary
The opioid epidemic is often viewed through the lens of addiction and overdose, but many pain patients benefit significantly from these medications. With the current regulations, long-term pain patients face challenges in accessing necessary pain relief, and discussions around opioids often overlook their medical necessity. Personal stories like mine highlight the importance of understanding the responsible use of opioids in managing chronic pain.
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