Chronic Pain Often Undertreated

OUR GOVERNMENT'S WAR ON DRUGS CAUSES PATIENTS TO SUFFER NEEDLESSLY

Millions of Americans suffer daily from chronic, nonmalignant, intractable
pain. Intractable pain has been defined as pain that is excruciating,
constant, incurable and of such severity that it dominates virtually every
conscious moment, produces mental and physical debilitation, and may
produce a desire to commit suicide for the sole purpose of stopping the pain.

Yet this horrendous pain largely goes untreated. Doctors find numerous
excuses. Some blame our government's insane War on Drugs and fear of the
Drug Enforcement Administration. Others claim their hands are tied by the
state medical and pharmacy boards.

Others worry about addiction. They pass this fear to their patients, in
spite of numerous studies showing that far less than 1 percent of chronic
pain patients who take opioids, including the now infamous OxyContin, have
addiction issues.

As a pain clinic nurse told me recently, all doctors could treat pain, but
unfortunately very few choose to treat pain. A patient who requests pain
medication is immediately suspected of being a junkie, labeled a
"drug-seeker" and treated accordingly. Some are told that the pain is all
in their head or are told to "tough it out." Often, patients are told that
they are depressed. Gee, I can't imagine why anyone living in constant
agony, treated like a drug addict and ignored or yelled at by doctors would
be depressed. I would be more concerned if they were not!

Four years ago my wife, Linda, was diagnosed with CFIDS (Chronic Fatigue
Immune Dysfunction Syndrome) and severe FMS (Fibromyalgia Syndrome). Her
chief symptoms were chronic fatigue, cognitive impairment and chronic pain
that approaches suicide levels. In less than a month, she was unable to
work. Six months later, she went on long-term disability. Once a
well-respected computer operator, she may never be able to work again.

After seeing first-hand the lack of understanding and willingness to treat
pain, I'm surprised the suicide rate of these sufferers is only 900 percent
of the national average.

Only Opioid Medication Helped

For over a year, Linda's pain was grossly undertreated. She tried numerous
"alternative modalities" -- acupuncture, physical and massage therapy,
chiropractic, antidepressants, NSAIDs, psychiatric and psychological
counseling, etc. The only thing that helps is opioid pain medication.Many
pain clinics use physical therapy, counseling and small amounts of opioids.
However, trying to exercise the pain away does far more harm than good for
patients with CFIDS/FMS. Another approach involves prescribing
antidepressants to trick the brain into thinking that the pain isn't as
severe as it really is. I'm convinced the purpose is simply to turn
patients into zombies who don't complain as much.

My wife was shuffled from one pain doctor to another. We were eventually
referred to a specialist in Chapel Hill, who unlike past doctors, actually
listened to us. He understood the inhumanity of telling patients that "pain
management" means that they have to "manage to live in pain for the rest of
their lives." He knew the difference between addiction -- a psychological
craving, even though no benefit is gained and harm is done -- and physical
dependence, which occurs when the body becomes accustomed to opioids and
has withdrawal symptoms if the medication is suddenly stopped.

As a result of being on an adequate amount of opioids, Linda was able to
get out of bed every morning, live a semi-normal life and not obsess on the
pain.

But like most things that seem too good to be true, it didn't last long.
The pain doctor decided he no longer wanted to treat patients outside of
the Triangle area. This contributed to her local doctor becoming more
uncomfortable writing such high levels of opioids.

We spent all of 2002 trying to find another pain doctor. We were not able
to find anyone to continue the opioid therapy or perform an opioid
rotation. Despite repeatedly reassuring my wife that he would not abandon
her, the Chapel Hill doctor sent a certified letter giving her 30 days to
find another doctor. He refused to listen to reason and knew full well that
if we couldn't find another doctor in a year, we probably couldn't find
another doctor in a month.

Like the majority of chronic pain patients who do nothing wrong and don't
abuse their medications, we now have to find a way to continue treatment
before she goes through withdrawal.

Bring back over-the-counter heroin

The Libertarian philosophy on the drug war is that it should be put out of
our misery immediately. If this were to happen, those few doctors who
aggressively treat chronic pain could do so without fearing the DEA. Also,
people in chronic pain could buy whatever they needed for their level of
pain from any pharmacy without a prescription or insurance.

Prior to World War I, people could buy a measured packet of heroin for
pain, sold by Bayer, right beside their aspirin. This would go a long way
in helping many Americans, my wife included, who have an unbelievably poor
quality of life. Some may see this as one more reason to end the drug war.
Personally, I can't think of a better reason.