Disclaimer: nothing in this blog post should be construed as either medical or legal advice.
It was bound to happen. With politicians’ screams about the so-called “opioid crisis” reaching a fever pitch, I was bound to be personally affected by #opioidhysteria.
Those who have followed my blog, or read my big post about my chronic disease, know that I lost a successful military career to an incurable disease caused by toxic exposures courtesy of my own government.
One of the reasons why I was forced into early retirement by the US Air Force was my need for opioid painkillers on a long-term basis:
“SM” stands for “Service Member,” and note the second-to-last line, “SM’s fibromyalgia pain requires treatment with narcotic medications,” as well as the earlier note about “multiple medication regiments and interventions” being unsuccessful at treating my condition.
I’ve had a prescription for 50 mg of Tramadol, twice per day, for some time now. I have at all times used my prescription medication responsibly, and not upped the dose in spite of it being inadequate to prevent very painful evenings and mornings before the medication takes effect. Tramadol provides zero “feeling of euphoria,” “high,” or anything else that to my mind would incentivize abusing it. Tramadol is a very different opioid from say Vicodin or Percocet. Simply put, it doesn’t make me feel “good” or “high”–it allows me to minimally function by taking the edge off my chronic, unremitting pain.
I have a wonderful doctor who I think the absolute world of. So it pained me to learn that, like so many other conscientious doctors who care deeply about the well-being of their patients, mine too is being pressured to reduce opioid prescriptions. It’s not surprising, given all the hyperbolic talk of an “opioid crisis” by politicians, bureaucrats, and mainstream media alike. In fact, this “pressure” is not merely of the professional disagreement variety–doctors can be prosecuted criminally for prescribing too many opioids, and there’s been such a chilling factor thanks to politicians from both major political parties that many doctors are now afraid to prescribe opioid painkillers at all. I found this article which talks about the dramatic drop in opioid prescriptions and fears of doctors that they will be criminally prosecuted if they prescribe them.
So what’s a chronic pain patient to do? These articles here and here do a good job of explaining how #opioidhysteria has destroyed the lives of chronic pain patients who need these painkillers to maintain minimal functionality.
In fact, here’s a breakdown of just how regulated opioid prescriptions are, which, interestingly, also contains information about medical (and recreational) marijuana legalization by some prominent states in spite of it remaining very illegal under US federal law.
Weak, non-opioid painkillers such as Acetaminophen (Tylenol) and Ibuprofen (Motrin, Advil) are worthless for chronic pain patients such as myself. Simply put, they do not help with the pain. They are not nearly strong enough to be of any help. Moreover, both have serious side effects–much worse, I would argue, than my Tramadol prescription long-term. Take, for example, Acetaminophen, which should not be used for longer than 10 days, and if used long-term can destroy the patient’s kidneys and liver. Yikes. Then there’s Ibuprofen,which can also damage the patient’s kidneys, cause thinning of the blood/uncontrolled bleeding, and also cause heart attacks! It is also not recommended for use over 10 days, and note that neither of these medications is recommended for the treatment of other than “mild to moderate pain.” Sorry, those of us with severe pain, not only will these medications not work, they will potentially kill us if used long-term.
In contrast, Tramadol does not cause those nasty blood, kidney and liver side effects, and is prescribed to treat “moderate to severe pain.” And it does a good job at that. It’s also used for chronic pain patients, i.e. it’s safe to take for longer than 10 days.
Like any opioid, Tramadol has a risk of dependency and withdrawal if suddenly discontinued or improperly tapered. Still, chronic pain patients like myself have proven we are not addicts by using our medications as prescribed, in the amounts prescribed, and the rate at which we seek refills (which require a doctor’s prescription) is easily verifiable. So compared to ineffective pain killers, I say “hooray for Tramadol, and let’s stop all this opioid hysteria and targeting of chronic pain patients!”
Today I went in for a refill of my Tramadol prescription. This was by no means an unusual event. However, due to all of the new restrictions on opioid prescriptions, I was required to sign a Narcotic Use Agreement, because, obviously, I might be a drug addict who’s been masquerading as a patient with serious medical diagnoses these past 3 years:
I really didn’t have an issue with the agreement, because I’ve never abused my prescriptions and followed the 5 “rules” recited in the clinic’s agreement even before I was subject to such rules, because I am a responsible patient who cares about my own health.
The next step, however, was less pleasant: I was required to submit to a urinalysis test to make doubly sure I’m not a drug abuser masquerading as a patient with a serious illness. Now, I submitted to dozens of urinalysis tests during my time in the US Air Force, and came back clean every last time, and my test from today will come back clean as well. Still, the experience of being treated as a suspected drug abuser and forced to drug test, at a nearby lab along with folks court-ordered to do so based on criminal convictions/probation terms, was insulting to say the least. I am told that I will have to submit to a urinalysis test from now on every time I seek a refill of my prescription. Moreover, I am concerned that my doctor might come under fire for continuing to have the courage to properly treat patients like myself, something I would very much hate to see.
So what is next for me? Well, I’ll continue to speak out against #opioidhysteria along with the many other chronic pain patients who have been harmed by this ill-guided and unsound policy of politicians and bureaucrats imposing their superstitions and one-size-fits-all “solutions” on doctors, and adhere to the terms of my Narcotic Use Agreement. But now I get to worry about being “cut off” and forcibly tapered off my Tramadol prescription because opioids are now “evil” and apparently so am I for getting sick and needing them.
Long term, it seems I’ll need to seek a substitute. Massage and acupuncture are the sorts of treatments that in addition to being expensive, have very temporary pain relieving effects. I have not tried CBD oil, in large part because marijuana is illegal under US federal law in spite of my state, California, legalizing marijuana for all uses–medical and recreational, and until recently I was career military and very used to following the law. The DEA, at least, seems to believe CBD oil is illegal under federal law, although obviously there are not enough federal law enforcement officers, and more importantly, not enough federal prosecutors, to effectively prosecute individual marijuana users (or CBD oil users) in states like California where marijuana is legal.
CBD oil sounds promising, as it appears to have pain-relieving effects without the “high” caused by THC. Still, its possible illegality under US federal law makes me very reluctant to consider tapering off opioids and moving to CBD oil (which I don’t even know for sure would help with my chronic pain).
Thank you to those who have driven the #opioidhysteria movement. While you may have had good intentions, chronic pain patients are greatly suffering due to your efforts. Congratulations.