Earlier this week, the attorney for a California-based addiction doctor stated that arrangements had been made for the artist and singer Prince to seek treatment for painkiller addiction shortly before his death. (Prince died at his Paisley Park studio complex in Minneapolis on April 21. He was 57.)
It’s important to remember that it will be weeks, possibly months, before the results of Prince's autopsy and the cause of his death will be finalized. Until then, we need to consider information in the public sphere with a great deal of skepticism.
We do know that Prince had long-term hip problems with high levels of chronic pain and reportedly used Percocet to treat that pain. Sources also indicate that prior to his death he had the flu, which turned into walking pneumonia. Being sick with pneumonia can affect your cognition, possibly affecting how you take medication.
Regardless of what happened, it is inevitable that the attorney's statement will enter the discussion about opioid painkillers. The rumors of a possible overdose will likely take over the conversation, further demonizing the use of opioid painkillers. This is unfortunate, as the real question here, as stated in the L.A. Times, is whether Prince received appropriate care.
Facts about addiction and opioid painkillers
The conversation about treatment of pain is becoming increasingly one-sided, with the arguments that opioids are uniformly bad and inevitably cause addiction so loud and incessant that few other voices can penetrate the noise. It has led to the CDC recently releasing prescribing guidelines that discourages general practitioners from prescribing opioids for chronic pain.
People do become addicted to opioids, but some important facts are missing from the debate. A meta-study showed that when opioids are prescribed and taken correctly, the rate of addiction is one quarter of one percent. Another review of 67 studies showed that when including people who had previously been addicted — this being the highest risk factor for addiction — the rate of addiction increased to 3.3 percent. (1)
This means that if prescribed and taken correctly, 97-98.75 percent of individuals taking opioid painkillers will not get addicted. Unfortunately, instead of focusing on educating physicians about how to prescribe opioids so they can help their patients take them correctly, some legislations and regulations are taking aim at restricting these types of medications.
One of the largest healthcare organizations in Tennessee will no longer prescribe opioids painkillers on a long-term basis at two of its pain management clinics. In New York State, pharmacies are only allowed to receive a certain number of opioid painkillers per month, limiting how they can dispense medication to those who need it. The ripples are expanding and we who live with high levels of chronic pain are caught in the maelstrom.
The impact of stereotypes
There are times when I despair of sanity ever prevailing in this fight — when I worry that those of us who need opiate painkillers to make it through the day will never be heard as legitimate voices on this issue. When I was at university, I took a course in the sociology of how attitudes are formed. I remember a discussion about stereotypes and the professor outlining how events that confirm a negative stereotype will be noticed, whereas your brain will skip events that do not support the stereotype. For instance, if you believe that women can't drive, every woman who makes a dumb move in traffic will confirm your stereotype, but you will not notice the women who drive well.
Our culture is increasingly accepting the "truth" that opioids are dangerous drugs that inevitably lead to addiction. Whether Prince overdosed or not, the speculation is out there and for countless people, it will confirm this "truth," lending more pressure and support to the efforts to restrict — perhaps even eventually ban — narcotic painkillers.
What can we do?
I am a health advocate and as such, I have to believe that we can make a difference -- that our voices can and will be heard if we only keep trying. This means talking to friends and family about the difference opioid painkillers make in our lives, about how they enable us to actually live our lives — go out to dinner, work and go to school, play with our kids, be active in our communities. How without them, we would be stuck on the couch, in bed, or perhaps even be suicidal.
We need to talk about the reality of chronic pain and the impact it has on our lives. That it isn't just a bit of pain that can be handled with over-the-counter drugs, some exercise, or perhaps an ice pack. We need to tell people that the pain of moderate and severe rheumatoid arthritis, for instance, has been likened by some doctors to the agony of bone cancer. We need to contact our elected representatives and pressure them to include both sides of the story when debating any new, restrictive legislation.
We need to safeguard the public against addiction while also protecting the rights of people with chronic pain to have their — to have our — pain treated effectively.
I hope that you will join me in making some noise about the benefits of opioids. And perhaps the growing rumor about Prince's untimely death will, ultimately, lead to valuable conversations — and an increased understanding of the nuances — around this critical issue.
See More Helpful Articles:
Helping Others Understand Your Pain
Opioids: Addiction Versus Dependence
Myths about Opiates and Addiction Affect Pain Management
Pain Management in Recovery and Addiction
Chronic Pain and Multidisciplinary Treatment
(1) The National Opioid Use Guideline Group, Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (2010): 10.
Lene writes the award-winning blog The Seated View. She's the author of Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain and 7 Facets: A Meditation on Pain_. _