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Pain Meds Don’t Create Drug Addicts

There are all kinds of problem with narcotic pain pills. Patients become tolerant and require higher and higher dosages. Eventually, the pills can cause hyperalgesia, or an increased sensitivity to pain. Based on an informal review of the literature, though, the biggest perceived problem is the high number of people who become addicted to pain pills. When their doctor won’t prescribe any more of it, the patient tries to get it illegally, or moves on to easier to obtain opioids like heroin.

After dealing with coming off pain medications recently, it’s clear to me the problem isn’t that normal people become drug addicts. It’s that normal people aren’t taught how to get off the stuff.

On May 9, 2015, I awoke to a bad pain on the outer side of my left hip. Within a few days, it progressed down the leg. Within a month, I was essentially disabled from the pain. It turned out to be spinal stenosis in my lumbar region. That’s the lower back. MRIs showed my spine had developed spurs and had degenerated such that it was pressing against nerves that exit the spine and move down the leg, hence the pain. I was given the choice of getting shots that would put medicine on the nerves to temporarily numb the pain, or have surgery. This wasn’t going to get better. My spine wasn’t going get undegenerated. I chose surgery. It was going to be necessary someday, and I wanted to get it done while I was still in excellent physical shape rather than wait until I was feeble.

A quick aside here – I’ve seen no medical opinion blaming this condition on running. It is a genetic issue. My mother was crippled by stenosis when she was in her seventies. Doctors kept giving her the temporary relief of injections until it was too late to do surgery. That’s a major reason why I went ahead and had it done.

Before the surgery, I had to use a walker to get around. By bending over  and leaning on the walker, my spine opened up and took pressure off the nerves. Lying on anything was painful. I found two positions that had less pain and eventually I’d fall asleep. To move to them, I had to pull my knees to my chest and turn all at once. That hurt, but moving in any other way was beyond agonizing. The good thing was I was pretty much pain-free when sitting.

After the surgery, the pain got worse, just as my excellent neurosurgeon predicted. The surgery was a lumbar laminectomy. The spine has kind of a “D” shape with the curved part facing front and the flat part facing the rear, which is called the lamina. The surgeon cut about three inches of that flat part off and cleaned up some other stuff so it wouldn’t be pressing against the nerve. Problem is, all that cutting and manipulating of the nerve irritates it and causes swelling, resulting in the nerve causing pain all the time until it heals.

I had three months of unrelenting pain in my hip and down my leg in all positions – sitting, standing, or lying down. The walker didn’t help. It was bad. The recovery was like stair steps, rather than a curve. At three months, I woke one day and the pain was mostly gone when sitting. What a relief! But, the pain was still excruciating wen walking or lying down. As time passed, different things quit hurting at different times until everything quit hurting almost exactly five months after surgery.

During all that, I took pain meds. Lots of them. Narcotics and some other stuff. At one point, to keep up, I had to create a list of what to take when.

Pain Meds Pos-Surgery

Daily Medication schedule

As the pain diminished, I came off the pain meds. The first was the daily 1800 milligrams of  gabapentin just about a month after surgery. The withdrawal was godawful. At about the four month point, I came off the opioids. That was just as bad.

It took several weeks to titrate off both. I cut the dosage in half, then half again, then half again and so on until I was done. The same pattern occurred each time. My cut down day was Monday. I’d feel  OK on that day. On Tuesday, I’d feel a little funky. Wednesday, Thursday, and Friday were bad. I felt like I had a severe case of the flu – achy, fatigued, and nose running. I cried at pest control commercials . . . or nothing – just be sitting there and start bawling. On Saturday and Sunday, I felt normal. Then, it would start again on Monday.

That was a total of about eight weeks of hell, with a couple days of respite each week.

As I was going through the bad part, I used all the tools I’d learned in recovery from alcoholism. I made sure my wife knew what was going on. I called other recovering friends who reminded me of all the stuff I could do to get through the hard times. I had been through alcohol withdrawal and from that experience, I knew I would survive and feel good eventually. I lived one day at a time and didn’t worry about the possibility of never feeling good again. I handed it over. And, I gave myself permission to eat a little ice cream.

Normal people don’t know how to do all that stuff. Their fear must be massive. They have no experience telling them it’s going to get better. The only solution they have is to take another pill. Eventually, they run out of them and the doctor won’t give them anymore. Their only answer is to go out and find some from wherever they can – like in their best friend’s medicine cabinet or on the street or by doctor shopping. Prescription drugs are hard to get long term, though. So, in desperation, they go to street drugs like heroin.

There is no doubt in my mind people don’t “become” addicts or alcoholics. We alcoholics are different in the way we react to beer, wine, and liquor. Drugs addicts react to opioids differently. We can’t stop taking alcohol or drugs because our bodies react differently to the substances than normal people.

When normal people keep taking drugs, it’s because they have no other solution to feeling incredibly bad when they quit taking them.

When patients are prescribed narcotics or other pain meds like gabapentin, they should be required to be involved in some program designed to give them a strategy for coming off them. Perhaps a required seminar on what to expect, then phone numbers of supportive volunteers to call when they are really hurting and want to take more pills.

I’ve read all the opinions suggesting pain medication should not be prescribed. The alternative suggestions are physical therapy, behavioral therapy, and intense psychological counseling. I did the PT and I’m extremely knowledgeable about the other two. We really, really, really need a Mr. Spock machine that would allow these people to feel the pain I was feeling. Let me tell you, the pain meds were critical to my getting through those terrible months.

But, thank God I knew how to get off them.

1 comment

  1. glen

    thanks ed i agree….here in canada now they dont prescribe real pain meds anymore unless your terminal, tylenol 3 is as strong as it gets, cause they created a a whole whack of addicts in the 90’s with oxy

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