Dependent Upon Opioids: A Call for Resistance

Patient Expert
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I had to take opioids to be able to write this article. Yesterday, I took opioids so I could meet a friend for lunch. The day before that, I tidied up my living room and — you’ve guessed it — opioids then helped me to be able to go grocery shopping instead of spending the rest of the day just breathing through the pain.

It’s difficult for others, including lawmakers and doctors, to understand this kind of pain. People who have not experienced severe chronic pain don’t understand that it is akin to a wildfire razing your life, leaving only ashes in its wake. It is moving through your day feeling as if you’re walking on broken bones or engulfed in flames. It is the kind of pain that makes you look favorably upon hacking off limbs, trepanning, and even death. It disables our bodies, changes our brain structure, and leaves us isolated and lonely.

The heartbreak of untreated pain

Recently, I asked members of the chronic pain community to share their feelings about the war on opioids and its impact on their lives. Reading the responses was heartbreaking. People shared their experiences of having to live on reduced prescriptions or not being able to get a prescription for opioids at all. They told me about waking up crying in the middle of the night because the pain is overwhelming; of being treated like a criminal; of the pain preventing them from being the friend, spouse, and parent they want to be.

“Seventy-five percent of people who misuse opioids become addicted after taking medications that were not prescribed for them.” -Stat from the National Survey on Drug Use and Health

And the thing is, most people who take opioids for chronic pain do not get addicted. In fact, exposure to opioids result in addiction in only a small percentage of people. A review of studies showed that if prescribed and taken correctly, the rate of addiction is one quarter of one percent. As well, the annual National Survey on Drug Use and Health repeatedly shows that 75 percent of people who misuse opioids become addicted after taking medications that were not prescribed for them.

But facts don’t seem to matter much in the war on opioids. Instead it relies heavily on hyperbole, scare tactics, and inflated statistics. Don’t get me wrong, I am not belittling the tragedy of opioid addiction and overdose. I am, however, trying to shine a light on the human cost of using a simple solution to a complex problem.

Consequences of non-treatment of pain

In 2010, the International Pain Summit met in Montréal and signed a declaration. This became known as the Declaration of Montréal and it states that access to pain management without discrimination is a human right.

If you poke around a bit in the field of human rights — bear with me, I have a point — you will very quickly come upon the United Nations Universal Declaration of Human Rights. Article 5 states that “No one shall be subjected to torture or to cruel, inhuman, or degrading treatment or punishment.”

Restricting, withholding, or outlawing certain kinds of pain treatment without offering an equivalent that is as effective may be a human-rights violation, because preventing someone from getting the kind of treatment that may be the only effective way to control their pain is akin to torture.

Yes, I said it. It is cruel and inhumane to tell a person who has severe chronic pain that they cannot get a particular medication, but should try yoga or meditation or some anti-inflammatories instead. Although all of these and more may be part of that individual’s pain-management toolbox, leaving out that additional tool called opioids may very well make the difference between a life with tolerable pain and one where every moment of every day is accompanied by unmanageable pain.

Resistance

I am dependent upon opioids. And I’m not talking about the physiological kind of dependence — this is about the ability to make a living, to have friends, to help my family, to sleep the night through, to laugh, to love. Opioids do not take away my pain, but they reduce it enough that most days, I can do all of those things. Most days, I can have a life.

I watch the war on opioids and like so many others who depend on this medication, I worry. About access, about prohibition, about the impact the ever-tightening restrictions will have on my life.

I share the reality of my life with severe chronic pain in the hope that adding my voice to the debate might make one more person start to ask questions and insist upon nuance. I refuse to be silenced, refuse to be left in the shadows. And I do it as a form of resistance in this war in which I and so many like me have become collateral damage.