It’s an ongoing debate in the medical community and among those who suffer from chronic pain: is it worse to suffer from pain or deal with addiction to the opiate painkillers prescribed to alleviate that pain? According to Medical News Today, the debate continues and neither side of the argument shows signs of giving way.

No one thinks that opioid-based medications should be done away with completely. Obviously. Chronic pain is an issue of quality of life and we live in a scientific age that allows us to live free from pain. Doctors struggle with the legal implications of possibly affording someone a prescription for illicit purposes as well as the ethics of treating their patients to the best of their ability.

What the Professionals Have to Say

Srinivasa Raja, MD is a professor of anesthesiology at Johns Hopkins University Medical School. He says: 

“Physicians today face a dilemma in trying to balance the needs of their patients with demands from society for better control of opioid medications. We also are dealing with unfounded accusations in the media that increased prescribing of opioids for severe chronic pain is responsible in large part for reported upswings in the abuse of pain medications.

“We do need stronger evidence about which patients will benefit most from these medications to help make better prescribing decisions.But for most chronic pain patients, drugs are not the sole solution. More and more studies are showing that multi-faceted treatment involving physical and cognitive-behavioral therapies and appropriate interventional strategies lead to the most favorable outcomes.”

The American Pain Society

The American Pain Society is “a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.” They believe that the best way to deal with the problem of prescription drug abuse is through the collaboration of the medical and legal communities as well as the pharmaceutical industry.

Says Raja, “First, I believe physicians should be diligent is communicating with their patients about the benefits and risks of opioids and also screen them for drug-seeking behavior and other warning signs of potential abuse. Also, we must monitor patients carefully to determine when doses can be lowered over time as they improve their pain control and overall functioning.”

What do you think?

Well! It’s been a while since I’ve made a post here, and I have missed y’all something terrible, but I can’t think of a better reason to break my writer’s block than this:

This week marks the six-month anniversaryof me beginning Suboxone treatment! Woot!

I can hardly believe that a half of a year has already passed, and so it seems like a good time to take a moment to reflect on where I came from, and where I am now.

Six months ago I was a huge mess. I was in constant pain, physically and emotionally. I’d been using opiates nearly every day for the previous year, progressing from hydrocodone to morphine and dilaudid. My life slowly and steadily constricted around me as I let go of people and activities I cared about because all I had energy for was getting high.

I dropped out of school, telling myself I’d take the quarter off to rest and get my health back - but that quarter stretched to another and another. Work wasn’t going well. I was unmotivated, lethargic and frankly, my attitude was total crap. Home life wasn’t much better - even my beloved daughter was starting to feel more like a burden to me than a joy. The worst, though, was the way I felt about myself.

I knew I was out of control. I put off paying bills because I needed drugs to stave off the dopesickness that constantly threatened to take me down. My tolerance grew so much over the previous summer that I couldn’t even get pain relief any longer, and getting high was out of the question. Over and over I tried to quit and suffered through the pain of withdrawals for days, sometimes even a week or more, only to use again at the first chance I had. Still, some twisted sense of pride kept me from admitting that I was in over my head and I needed help.

During this low-point, I became aware of this new drug called Suboxone, and it’s great potential to help people like me - opiate addicts. Did I call for help the first time I heard about it? Oh, no way. I was scared, and embarassed. But I was also intrigued, so I sought out information online. And the more stories I read, the more I became convinced that this drug could help me too.

So I finally made the call, and got into a treatment program and started taking Subxone. That was six months ago, and while it hasn’t always been smooth sailing, I definitely stopped my ship from sinking and steered it to safer waters. (to torture a metaphor, sorry!)

What does my life look like, six months into treatment? Well, I’m glad you asked, because things are great!

Because I chose, based on my substance abuse history and other mental-health issues, to go with a longer-term replacement type treatment with Subxone, I still take Suboxone every day. I’ve decreased my dose quite a bit, with an eye toward tapering off completely in the next six to eight months. I also go to therapy once a week, and I have a “recovery plan” that keeps me involved in activities that are healthy and fun - like yoga, dance, swimming, writing, and blogging.

Family life is so much better. The best thing is that I can now handle the inevitable rough-patches without turning to drugs, and sometimes I even manage to hold on to my peace of mind during the hard times. I’ve navigated some serious health issues lately without completely losing my balance, and I’m quite proud of that. I’m doing better at work too, and have been given new responsibilites that have made my job fun again.

The thing I’m most proud of, though, is that I returned to school for the Spring quarter and if all goes well, I will finally complete my Associate of Arts degree after only 15 years!!! Well, not that I was in school for that whole time, LOL, but it did take me a while. The class I’m taking this quarter should complete my degree, and I can transfer to University next year. I can not tell you how incredibly good it feels to be getting on with my life.

And, more than just getting on with life, I have goals again. Addiction steals our goals, our hopes and dreams, sometimes to the point that the only thing we’re living for is the next opportunity to get high. That is such an incredibly painful way to live, so I’m beyond happy to have found that I don’t have to live that way anymore. Nobody has to live like that - there’s help for us all.

Suboxone didn’t do all the work for me, but I doubt I could have come this far this quickly without it. If you’ve been thinking about calling, wondering if this drug could help you too - all I can say is Make The Call. I sincerely believe you won’t regret it.

A few weeks ago, I posted an interview here with a man who was on methadone maintenance. It garnered quite a few responses, and so he asked me to follow up and let you know what’s happening with him. To preserve his anonymity, I’ll call him Smith.

On April 6, Smith was arrested for a parole violation. Because the jails are overcrowded, they quickly sent him to San Quentin where they do not supply inmates with methadone for any reason. Smith is on methadone for pain management and 110 milligrams in liquid form for drug addiction maintenance. For the third time in six months, he was forced into a cold turkey detox off of methadone. The result was the same this time as it was the last two times: misery. He sent me a letter:

Hi, Valeria. I’m not doing good. What they’re doing has to be unprofessional if not unethical. I’ve had to be taken to emergency five times now and every time they tell me they don’t have what I need but, “Here’s a little of this or a little of that.” Now it’s MS Contin two times a day but at first it was Motrin, naproxen, a non-narcotic shot in the hip that didn’t do anything.

I don’t want to scare you or worry you anymore than you probably already are, but I think it’s important for you to know for your blog. The morphine is helping with the twitching and sweating, nausea, etc and my eye doesn’t hurt but I’m still really dizzy and I can’t sleep. Methadone is a f**king powerful drug, man. Even morphine can’t touch it. I’m delirious. I think this is day 9 and it’s just climbing. Every nerve in my skin feels like it has a low voltage electric shock going through it. I can’t hold down any food or water and I am constantly covered with slick, oily, cold sweat. It’s getting unbearable and still, still I can’t imagine when this will be over. I am miserable. When I get over this, I will have to reevaluate my whole pain management system. I can’t go back on methadone, man. This is too high a price.

So there you have it. And for the record, Smith’s violation is not drug related. He was clean when they picked him up, and he is now at the end of his third week of methadone detox. As of the 25th, he still hadn’t slept, and he’s lost 20 pounds.

If you are addicted to any opiate drug in any form for any reason then you are at risk of experiencing a cold turkey opiate detox. You never know what is going to happen. You could lose your insurance, your pill bottle, lose your job and run out of money to pay for the insurance or the medication. You could go on vacation and forget your meds and be unable to fill the prescription. Anything can happen. Prepare yourself.