Wednesday, February 17, 2010

Relevance of an 'Addictive Personality' in an Octogenarian

When I spoke to a close family member a couple of days ago, I was outraged to discover that her doctor had balked initially at the option of giving her any real painkillers but ultimately prescribed a handful of Vicodin with the remark, 'I will do this because you don't seem to me to have an addictive personality'.

The woman she was treating is almost 80 years old, suffered a radical mastectomy in her 30s and as a result has severe lymphedema. Doctors have been willing to POISON her with all sorts of radiation treatment, to butcher her body so that one entire side of her torso is concave, destroying her balance, and change her essential BEING and the workings of her brain and system by prescribing tricyclic antidepressants and neurontin for pain now instead of giving her a simple true painkiller. Note here that tricyclic antidepressants and neurontin have far more negative, even dangerous side-effects than any true analgesic painkiller.

This woman NEVER abused any chemical substance in eight decades and even when prescribed painkillers in the past, always waited until the pain became intolerable before she downed a single half grain of codeine.

To me, this only serves to highlight the absurdity of the negative stereotype of 'drug addiction'. True analgesic painkillers such as codeine or morphine act only on the central nervous system. Is it the puritanical obsession at the foundation of American society that has lain at the heart of the widespread official disapproval of pain medications or is it a real medical concern? I believe it must be the former, as medications that actually damage the human body and mind are approved and promoted again and again in lieu of simple analgesics.

This patient suffered from excruciating 'shingles' recently and it was only after weeks of agony that the doctor finally gave her some Vicodin and Lidoderm patches, with the idiotic comment about her not appearing to have an addictive personality.

What on earh is an addictive personality? All human beings have 'addictive personalities' to some extent. We are addicted to other people, to our relationships, our homes, our daily rituals and our hobbies. We are 'addicted' to some extent to our favourite foods and beverages. Human beings crave discipline and structure and 'addiction' is a misnomer in many cases for that.

If a person lives in severe chronic pain and takes a tablet for it every 6-8 hours, is that a case of addiction, need or simply a way to solve a problem? Moderation in all things should be the standard of measurement where anything, including pharmaceutical substances is concerned. An 'abusive' personality is more to the point when considering whether or not to prescribe a painkiller than an 'addictive' personality.

Finally, it has been the practice in society to treat physicians as Gods and patients as Children. A patient ultimately should be trusted to know what is best for him/her. Why should a doctor be able to control the access and administration of painkillers? Alcohol, a far more damaging and dangerous substance than any pharmaceutical painkiller, is sold WITHOUT prescription to any one who has attained a specific age. Yet codeine, once sold 'over the counter' throughout most of the world, is not available without prescription in the U.S. and obtaining a prescription is a matter of a physician's discretion. Proving legitimate pain NEVER is the sole basis for prescribing a painkiller.

That must change. With the creation of Pain Management, it has changed to some extent, but in order to be accepted into a Pain Management situation, one usually must have exhausted all other possibilities. In other words, Pain Management fundamentally is designated as the last destination for the 'hopeless' and 'incurable' cases. Endless tests, surgical procedures and all of the expense and agony involved are the price one must pay before one is introduced to Pain Management. Again, the patient is not allowed to decide his/her fate at the outset but is treated like a Child and refusal to participate in any course of treatment ordered by a physician carries with it the possible threat of total exile.

The photograph shows the current Queen of England, herself an Octogenarian like the woman who recently was denied legitimate pain relief for a fortnight before a doctor finally deigned to allow her a meagre amount of medication. Although Queen Elizabeth is the ruler of one of the 'great' civilisations of the world, she probably defers to HER physicians where medical treatment is concerned. She is an educated woman of vast experience and considerable power and yet it is doubtful that she would tell her doctors what to do. The woman who is my relation is educated and has held public positions of some influence in the past. Yet we ALL are educated to believe that doctors have the right to dictate to us where our own bodies (and souls in terms of 'mental health') are concerned.