Message from the Editor: A Crisis In Pain Management

A Crisis In Pain Management

Let’s start off with some facts from the National Institute of Drug Abuse (https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis):

  • Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
  • Between 8 and 12 percent of people using an opioid for chronic pain develop an opioid use disorder.
  • An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
  • About 80 percent of people who use heroin first misused prescription opioids.
  • Likelihood of developing an opioid use disorder depends on many factors, including length of time a person is prescribed to take opioids for acute pain, and length of time that people continue taking opioids (whether as prescribed, or misused).

I never really understood how anyone could get addicted to opioids. I thought that those that did get addicted were probably pre-disposed to addition – had an addictive personality.

Then I found myself in a similar situation.

I was born in the last year of the baby boomer generation. I like to do things myself. I can still do everything I did when I was younger.

Or so I thought.

Pulling out some dead shrub roots I felt a pop in my back. For a week the pain wasn’t bad. Then on July 4th I woke up and the pain was so bad I couldn’t walk. OTC pain meds had no effect. 

I can best describe the pain as having a hot knife covered in glass shoved under your skin and moved around.

Two days later I was in the Emergency Room because I couldn’t take the pain. They gave me a series of increasingly powerful pain meds – Tramadol followed by Percocet, and finally morphine (cross that off my bucket list). Nothing helped. An x-ray didn’t show anything. Finally, an MRI revealed the cause. I had a herniated disc in my lower back that was impinging on a bunch of nerves that run down my lower back, hip, groin and end at my knee.

I was discharged with prescriptions for a round of steroids and Percocet and instructions to contact a spine doc.

It’s at this very point that I think things go wrong for so many people.

If you don’t have good insurance, if you don’t have a good support system (family, etc.) you can find yourself at the mercy of a healthcare system that was overworked prior to the pandemic and is barely holding it together now.

I got an appointment with a spine doc but I had to wait five days to see him. All this time my pain was close to a 10 on a scale of 1 – 10. I couldn’t sleep, I couldn’t find a comfortable position. It was torture.

Now imagine that you don’t have good insurance, or you would have to pay out of pocket for office visits, and tests, etc.

If you are experiencing intolerable pain, like I did, I can see how the desperate need for relief can turn into a search to find pain meds, from any source.

I can totally understand now how normal people can get addicted.

When the pain is so bad you are writhing on the floor existing from breath to breath and desperately watching the clock in anticipation of your next dose of pain meds – your mind quickly looks for pain relief from anywhere – regardless of the long-term consequences.

The opioid crisis was not solely made by pharma companies, or doctors, or patients. It’s a systemic problem where health care providers are overwhelmed, patients are often prescribed opioids and sent on their way with instruction to follow up with a doctor. Which they won’t or can’t based on financial or other reasons. Popping opioids then becomes the only solution – and often leads down the slippery slope of addiction.

There is a crisis in pain management in this country which has only been exacerbated by the COVID-19 pandemic. I truly feel bad for people caught in this situation.

The pain is real, the struggle is real. I wish there was a real solution.

Mike Auerbach

Editor-In-Chief

[email protected]

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