Thursday, December 11, 2008

Painkillers and Choice in Chronic Pain

The popular terminology for medical conditions never ceases to amaze me. In the past few years, 'pain issues' has become the accepted description for anything from migraines to the agony caused by terminal illnesses.

Mention 'pain issues' and society nods its collective head without demanding any gruesome details. Talk about specifics and the magnifying glass comes out...

When I think of my own 'pain issues', I think in terms of the onset of puberty, with its excruciating migraines and cramps, but that actually is NOT accurate. Pain came to me earlier than that, with terrible pains in my left leg that were dismissed simply as 'growing pains'. Were they? Who knows? It really does not matter at this point, although the severity of pain in my left leg is far worse still than the pain in the right leg. If some one had taken an interest then, would my life be different now? Doubtful. In any case, blaming any one or any situation for a severe chronic pain condition is counter-productive. Although I could make a legal case against specific members of the medical profession for my physical condition, to focus to that extent on it would be to make it far too important an aspect of my life. My own philosophy, tested over the years and found to be the best in terms of mental and physical health is: Mitigate the damage and move on.

The only purpose of this extended introduction is to make it clear that I have been familiar with serious pain medication from childhood and my relationship with that medication has varied according to the whims of the medical profession, the 'morality' of society and my own situation from year to year.

All this brings me to a very simple basic premise: When 'heavy' pain medication is available and plentiful and it is the PATIENT'S choice whether or not to take it, one tends to use LESS of it!

I lived through more than a decade when painkillers were dispensed in niggardly fashion, when one had to beg doctors for assistance and then be refused, when one had to create a false persona and playact desperately in order to receive any sort of medication for pain. While famous actors and musicians (and even the spouses of heads of state) managed to procure infinite quantities of pain medication, damning the truly needy by their irresponsible habits, we who lived on a more mundane level had to suffer for THEIR sins. Betty Ford, Nancy Reagan and others of their kind made OUR lives more miserable than we deserved, adding injury to the insult of chronic pain.

Then came a new era with the blessed relief promoted in the philosophy of Pain Management. Those of us who are condemned to a lifetime of relentless pain now have our natural dignity restored to us. Society may continue to shake its head disapprovingly whenever 'morphine', 'methadone', 'codeine' or 'fentanyl' are mentioned, but the powers that be have given us a new lease on life by recognising the fact that pain medication can make the difference between a life lived eternally on the cusp of hell and one that actually can have some elements of normal existence restored to it.

Addiction remains a dirty word, and when an individual mentions any truly effective pain medication, the first response of the ignorant is to warn against 'addiction'. How can these individuals not comprehend the fact that 'addiction' is far less of a danger or threat than the hell of relentless pain??? Those of us who are 'addicted' to life may choose 'addictive' pain medication over less effective options in the interest of restoring the elements of existence that most people hold dear: friends, family, and interest in life and the pursuit of ordinary happiness!

When a patient had to go to the 'Emergency Room' for an injection of morphine, wait three hours sometimes to obtain it, always with the threat of refusal attached to the entire affair, the pain itself would escalate to the point where NO injection truly could 'manage' it properly. Furthermore, all the playacting necessary to procure official acceptance was shameful in nature. You have to show you needed the medication without being desperate. Needy but not too needy, always concerned not to give the appearance of being a lowly 'drug addict'... and so on and so forth. It is difficult for me to forgive all the legislators and 'do-gooders' who placed legitimate pain patients in this predicament for DECADES.

What occurred then was that pain and its 'management' became the centre of existence.
The business of obtaining relief took on far too much significance and importance. It was deprivation that made pain relief into a religion!

Make pain medication easily accessible and the time and energy it requires diminishes vastly, giving one the freedom to truly focus on living.