It looks like the Drug Enforcement Administration has a new idea that they want to run by you: what if we allowed controlled substances to be prescribed electronically? It’s a little more than just an idea at this point, actually. It’s a proposed rule, which means that it will require a public comment period before it can be passed and certainly before it is implemented.

What Online Painkiller Prescriptions Would Look Like

Well, it’s a little unclear and that’s part of what the public comment period is for: to bring up possible problems and complications and then address them. Security requirements will more than likely be a part of that, to make sure that those who procure online prescriptions are actually who they say they are and in need of said medications. In short, that no one is stealing drugs or “diverting” them as they say for illegal purposes.

Controlled substances make up an estimated 10 percent and 13 percent of all prescription medications in the United States. Included in this proposed rule for online prescriptions would be Schedule IV medications (Xanax, Ambien, Lunesta), Schedule V medications (Lyrica), and even Schedule II medications that many struggle with (OxyContin, et al).

Online Painkiller Prescriptions Might Just Happen

The feeling I get from what I’ve read is that this is something that is being pushed for by a number of different groups, including Medicare. The DEA is hoping for it go through and would in fact conjoin the rule with a Medicare bill with the hope of encouraging physicians to adopt the practice. According to the Wall Street Journal, these might “finally lead to widespread adoption” of online prescriptions of controlled substances because many doctors “have been reluctant to purchase the technology because of concerns including cost and DEA restrictions.” In fact, according to Kaiser Daily Health Policy Report and Medical News Today, “fewer than 10 percent of U.S. physicians currently use e-prescribing.”

Do You See A Potential Problem with Online Painkiller Prescriptions?

Call me paranoid, but it seems like it’s already too easy to get prescription opiate painkillers. The online pharmacies that are currently in existence, even if illegally or internationally, are a huge part of the problem with ill-gotten prescription meds. Isn’t anyone concerned about hackers? If people can snag your credit card information, break into your bank accounts, find out your Social Security number and use it against you, then doesn’t it stand to reason that medical records including prescriptions if maintained in an online database could become subject to the same abuse?

This could all begin as early as next week. So what do you think? Is the convenience of online automation of prescriptions worth the possible abuse that could arise? Are you for it? Against it?

When I was using drugs, the idea that I might be an addict was a source of great shame. I wasn’t ashamed that I used drugs; that wasn’t my problem at all. No, I was ashamed that I’d lost control of my use, that I couldn’t quit when I wanted to, that I couldn’t handle the withdrawals.

I also didn’t want to be like “them”, you know: addicts, junkies. I wasn’t that sick, was I?

My use was out of control for a long time before I got help. I thought about getting help - but I didn’t want to say to my family: I am addicted to pain pills, and I need treatment. No way did I want my friends, or my job to find out. What would they think of me? How could I face everyone?

I feared the stigma of having “addict” all over my medical records too. Many of us know how doctors treat patients who are “drug seeking,” and I imagined it would be a hundred times worse if I was an admitted addict.

So I suffered, and I suffered some more. Finally, the suffering was worse than the shame (but only very slightly) and I decided to call for help.

What Was It Like?

Amazing. And scary, but not shameful. In fact, the health care professionals I’ve worked with throughout my addiction recovery - from doctors to therapists to research coordinators - have been some of the most respectful, kind and empathetic people I’ve ever known. It was among these people that I first began to really understand that my addiction is a medical problem, not a moral problem.

By the time I decided to get help, I knew I wanted to try Suboxone treatment. This meant I needed a diagnosis of “opioid dependency,” which required meeting with a doctor. My doctor was an addiction specialist, and he was so non-judgmental that it was a relief just to talk to him.

The first appointment was just me answering a lot of questions about my drug use. That was the scary part, but it was also really eye-opening. The questions were like:

• What kinds of drugs are you using?
• How much?
• How often?
• Do you ever drive when you’re high? (That was a big slap upside the head for me, I’m sad to say.)
• Do you do anything illegal to get your drugs?
• Do you hide your use from others?
• Does your drug use effect your job? Your social life?

By the end of that interview it was abundantly clear to me that I was addicted to pain pills. It was also clear that I wasn’t being judged for my problem, no one was going to slap a scarlet A on my chest and expose my faults to the world. I was among people who both wanted to help me and had the means to do so. I made an appointment to come back in a couple of days for my first dose of Suboxone.

When I arrived for my “induction” (that’s what they call it when you start Suboxone treatment) I was in moderate withdrawals as I hadn’t used in about 30 hours. I felt pretty crappy indeed, but hopeful too.

My doctor told me how to put the pill under my tongue and let it dissolve. I started with half of an 8mg pill, and went to sit by myself in the lounge and read a magazine. The taste was bitter and I wasn’t used to holding anything under my tongue like that, but my word…that first dose of Suboxone was a revelation.

Within 20 minutes my nose stopped running, my legs weren’t aching, no yawning, no coughing, no stomach cramps. It was like this huge wave of relief washed through my body. By the time I took the other half of my dose and walked out of the doctor’s office, I felt normal.

All day long, I felt normal - by which I mean good. I felt like myself, a feeling I hadn’t experienced in a long while. I had no cravings. I didn’t feel euphorically high, but I was in a good mood.

I went to work that day, and the next, and the next. I was able to fulfill all my family obligations and I even had the energy and inclination to do fun stuff on the weekend. It wasn’t perfect, but it was close enough. And I didn’t have to tell anyone what I was doing unless I wanted to.

I remember feeling sorry that I’d waited so long to get help once I realized what getting help would be like. I’m not saying that I took Suboxone and lived happily ever after. But Suboxone has given me the stability to sort out the mess that I made of my life, and to work on healing my body and my spirit. It also reminded me of how good it feels to be clear-headed and in control - now I don’t want to risk losing those things ever again.

What About You?

So what are you waiting for? There really is no need to suffer more, or for your addiction to progress further before you make the call and ask for help. Believe me, if I could do it, so can you.

Valeria’s recent post on dealing with triggers in recovery got me thinking about my own triggers, and the ways I’ve learned to diffuse them since I’ve been in Suboxone treatment.

One of my biggest triggers is pain. Pain is probably a major reason why a lot of us started taking opiates in the first place, and I know that pain is one of the biggest triggers of relapse. So what do you do when you’re in recovery but you still have pain?

First of all, I should probably point out that Suboxone is not approved for the treatment of pain and is not recommended for chronic-pain patients who need opiate medication to manage their pain. Readers of my blog probably know that I have fibromyalgia. I have chronic pain, but my doctors never agreed to treat my pain with opiod medication. They all said that the kind of pain I have doesn’t respond well to opioids.

Eventually I began using pain meds that I obtained illicitly in an attempt to self-medicate. This worked for a while, but as many of us know, treating chronic pain with opioids has a downside. My tolerance grew quickly, and it was difficult for me to obtain the drugs that I was now dependent on. Because the drugs masked my pain so well in the begining, I often pushed myself too hard and caused myself more pain, which required more drugs…a cycle that soon became incredibly difficult to break.

Suboxone helped me break this cycle, and it does help manage my pain. I’m fortunate in this, because Suboxone doesn’t work that way for everyone. But while it does help, it doesn’t take away my pain completely and I still have many days where my pain level is high enough to significantly affect my life. So what do I do now that I can’t (and don’t want to) turn to  pills?

My biggest coping mechanism is exercise (and I admit this grudgingly, as I am truly lazy). In my quest for greater physical and mental health, I’ve gone from being basically for sedentary to taking Tai Chi, Yoga, and Dance (Nia), plus swimming and walking. Some days require a monumental struggle with myself to get my butt to the gym, but it’s always worth it. I’m getting stronger and more flexible, and I feel better.

Exercise has another benefit, in that it increases the natural endorphins in our brains. Opiate addiction can cause our bodies to decrease or stop making endorphins, so anything that helps jump-start endorphin production seems like a good idea to me. I do believe it’s working too, because I feel so much happier when I’m exercising regularly.

Getting enough rest, eating right, spending time with friends and watching funny movies are other things that I can do for myself to help minimize my pain. I’m also learning to recognize my limits and how to ask for help when I need it. These habits keep me mentally strong and stable, so that I can deal with pain when it comes. I’m amazed at how much better I can deal with a flare-up when I’m well-rested and I’ve been enjoying life.

Examining my attitude towards my pain helped me a lot too. I realized that I could accept a certain amount of physical pain in my life and still be ok. I don’t have to be “comfortably numb” all the time any more. I also became more open to alternative ways of dealing with pain, instead of holding fast to my belief that only morphine would make me feel better. These days I use meditation, massage, ibuprofin, and cold or heat therapy to help me cope, and I’m looking into accupuncture.

Learning to deal with physical pain in my recovery hasn’t always been easy, and I’m certainly not perfect at it. During my active addiction, I got out of the habit of taking care of myself, and creating new habits takes time. Sometimes I do just wish I could take a pill and feel better, but that happens less and less the longer I’m in recovery. When it does happen, I’ve been able to use one of my new coping tools to get me through.

Of course, I have other triggers as well. I will write about how I cope with those in another post.