-- Margo McCaffery, RN, MS, FAAN, leader and pioneer in pain management for nursing.
Over the last 3 years I have been forced to become a student of chronic pain and a pain activist. The pain I've endured in my left shoulder has been brutal, unrelenting, and at times unbearable.
I'm finally emerging on the other side after having my shoulder replaced last May. They told me it takes about a year to completely recover and that's about what it has taken. In a month and a half it will have been a year since my surgery. I feel about 10/12ths in to my recovery.
My odyssey has been long. My story is long too. I'm going to add to it over the course of time. I've been treated like a junkie and fed falsehoods from the medical community that I knew weren't true. The medical community on the whole knows the least about this issue unless they're chronic severe pain sufferers themselves. They are being fed propaganda by the CDC which lumped street opiates in with prescribed opiates to come up with their bogus numbers. The medical community is operating out of fear and a very bad case of group think. The full truth will come out eventually. It's beginning to emerge right now.
Some of the things I've been told I know to be false because I've experienced it myself. They include:
"It's really the Acetaminophen (Tylenol) in opioid pain medication that provides relief from the pain. The opiates only provide euphoria."
This is patently false. No, it isn't the Acetaminophen that provides all the relief. Acetaminophen alone didn't even touch my pain, neither did Ibuprofen, and they were both tearing my stomach to shreds. Percocet (Oxycodone and Acetaminophen) did provide relief, and it had nothing to do with euphoria. It had to do with what works at relieving the pain and what doesn't. Opiates are by far the most effective pain reliever there is. Every one of the hundreds of accounts I've read of people suffering from chronic severe pain say the same thing.
In the course of being put through the wringer I was forced to try Lyrica, Cymbalta, Gabapentin, Amitriptyline, Nortriptyline, and Tramadol. I was taken to the highest recommended doses on all of them. None of them even came remotely close to the pain relief of narcotics (opiates).
It didn't matter to the doctors I went to, two "pain doctors," one orthopedic surgeon, my primary doctor, all of them said, "I'm not giving you narcotics and that's that." I literally could not sleep at night in any position without enduring brutal pain, and I mean brutal. None of them cared. They all fear the CDC and the DEA that much. They started telling themselves lies.
As it turns out the vast majority of pain patients don't abuse their medication and they don't die from it. It's worth repeating ... the CDC lumped deaths from street opiates like heroin and illicit pills in with deaths from prescribed opiates taken by pain patients, came up with one number, and called it "The Opioid Crisis."
At one point I was desperate so I called a medical malpractice group of attorneys to get their take on all of it. I was told, "You can't do anything to a doctor unless they actually harm you. We get calls every day from people literally crying, telling us their doctor took them off their opiate medication for chronic pain after 20 years. Most of them are in unspeakable agony. Their doctors don't care."
I didn't give up. I couldn't give up. The pain wasn't something you could "live with." A Naturopathic Doctor pain managed me with opiates for a few months before and after my shoulder replacement. The point came where she felt like she had reached the limits of her expertise.
I finally went to the pain clinic at Oregon Health and Science University. I found a bastion of sanity there. They deal with many of the tough pain cases in the region. They acknowledged the craziness taking place around this issue and told me mine wasn't a difficult case compared to most they see. They listened to my history and put me on the low-dose opiate regimen I needed. That was that. I've been tapering down per my own decreased need for pain relief as I reach full recovery.
The truth is starting to come out. I just ran across the best, most comprehensive article I've seen thus far on this topic. It begins to expose what is really going on. It's from Reason Magazine, the April 2018 issue. I highly recommend it. The title of the article is, "America’s War on Pain Pills Is Killing Addicts and Leaving Patients in Agony," by Jacob Sullum. Here's an excerpt:
In contrast with these harm reduction tactics, continuing attempts to discourage the use of prescription pain medication promise to cause a lot of needless suffering without making a noticeable dent in opioid-related deaths. Prescription guidelines that the CDC issued in March 2016, which minimize the benefits of opioids, exaggerate their risks, and encourage doctors to be stingy with them, exemplify this misguided strategy.
A 2016 critique published by the journal Pain Practice challenges several key aspects of the CDC document, including its recommended dose ceilings, its general declaration that nonopioid treatment is “preferred for chronic pain,” its suggestion that opioid prescriptions for acute pain last no longer than seven days, and its statement that doctors who decide to prescribe opioids should begin with immediate-release products rather than extended-release or long-acting (ER/LA) analgesics.
The criticism of that last recommendation sums up what is wrong with the guidelines in general ...
I'll end it here for today. This is only the beginning of my writing on this topic. This blog post will expand over time. I haven't even begun to tell you about the nightmare of the two "pain clinics" I went to before the university. Talk about humiliation. Again, I recommend reading the articles linked in this post. It's a lot of information to process. Those who suffer from chronic pain will feel validated after being treated like junkies and criminals by a medical community overcome by hysteria.