The War on Us

Patient Expert

When prescribed and used correctly, one quarter of one percent of people taking opioids become addicted. In some states, you can get arrested if your opioids are not in their original prescription containers (nevermind that such containers may be hard to open for people living with chronic pain). And if you somehow manage to find a doctor who's willing to prescribe "the big drugs", you may be required to sign rigid treatment agreements that can ban you from receiving opioids for life if you make the slightest mistake in taking your medication.

The War on Drugs marches on, no longer satisfied with targeting street drugs and criminals, but adding people living with chronic pain to their list of targets. And it makes me wonder what happened to the Hippocratic oath? What happened to "first, do no harm"? Is it not to do harm to withhold necessary pain medication? Because if you have the kind of pain that isn't just a minor inconvenience in your life, but the kind of pain that prevents you from doing much of anything other than having pain, the right meds can make the difference between spending your day just getting through it or living your life. The difference between pain that consumes all or laughing with your kids at breakfast before you go to work.

But I don't think you can blame the doctors, at least not exclusively. Sure, medical schools dedicate hardly any time to teaching new doctors about pain management and sure, there are doctors out there who "don't believe in painkillers" as if it were the newest religion, but is this not the reflection of a society that views pain and the need for painkillers with suspicion? Is it not a product of a larger focus on possible bad rather than possible good? The review of studies mentioned in my first paragraph shows that the risk of addiction is much, much smaller than the prevailing fear would indicate, but what if even 10 percent of people taking opioids became addicted? Would that be reason enough to put all these restrictions in place? The War on Drugs says yes, but the War on Drugs does not consider the 90 percent who do not become addicted (because there is a very big difference between being addicted and being dependent).

We forget about that, don't we, always looking at what can justify restriction instead of the other number, the larger number, the one that represents freedom, productivity, participation and joy. Instead of painting all with the brush of addiction, would it not be more reasonable to put programs in place to help the few whose bodies do react with addiction? Somehow, I think it would even cost less money...

Ah, the money. Let's not forget about the money. The War on Drugs is funded by the taxpayers and that means the taxpayers are funding this attack on people who live with chronic pain. Taxes pay for the FDA's initiatives to limit access to opioids, taxes pay for the programs that investigate as criminals the doctors who prescribe the big drugs and taxes subsidize the laws and policies that change our culture, obliterates compassion, create suspicion of the ill and withhold medication than can be necessary to live a relatively normal life.

The Geneva Convention sets the standards for humanitarian treatment of prisoners. What sets the standards for humanitarian treatment of pain patients? And that's another thing we don't talk about: what happens when pain meds are withheld. Because if your pain is big enough, living within it without relief can be akin to torture. But there is a tiny risk of addiction and so, too many people living with chronic pain are expected to just suck it up.

We who live with chronic pain pay taxes, too. We who live with chronic pain are voters, too. And perhaps it is time we start making noise, somehow dig up whatever energy isn't being used to deal with the pain and the doctors and the endless tests, time to stop living in the shadows and start talking to our representatives, the people who we have chosen to make the laws that govern us. The men and women who we trust to have the best interest of their constituencies at heart. Maybe it is time to remind them that their constituencies include people living with chronic pain, time to tell them what life is like under the thumb of the War on Drugs, time to insist that policy stop policing and instead look at the benefit of proper pain management.

You can read more of Lene's writing on The Seated View