Live with It!

Now, the federal government, in the form of the FDA, DEA and CDC want to severely curtail a doctor’s ability to prescribe painkillers to patients suffering from chronic pain. According to government studies, these patients turn to hard drugs like heroin when their prescriptions run out. This is the source of our drug problems and the driving force behind the transport and sale of illegal drugs. Opium based painkillers are turning patients into hardcore drug users.

So let’s theorize as to where this might be leading.

A patient with acute fibromyalgia has been on pain medication for several years. Over time, the dosage has been increased due to a loss of efficacy. Let’s say this person has been on hydrocodone, a common opiate painkiller. The patient progresses through  5mg, 7.5mg and finally 10mg dosages only to find the pain no longer dwindles to a tolerable level. Notice I said tolerable. More on that later. In an effort to give the patient the required relief, the doctor moves the patient to oxycodone or oxycontin. And then the trouble starts.

Doctors are increasingly failing to relieve patient’s pain due to a fear of the DEA and FDA. Prescribing maintenance doses of powerful pain killers raises red flags and brings the doctors practice under the malevolent eye of the regulatory agencies. The patient’s needs are of no interest to the government overseers. All they care about is regulating painkillers. If a patient is subjected to debilitating pain, in the mind of the feds, the patient just needs to learn to deal with it. The government is doing them a favor by not providing a path to hard drugs. Never-mind the pain is crippling and the lapse into depression leads to an increase in self-destructive behavior, perhaps even suicide. Better dead than addicted.

I am not saying that there aren’t doctors who abuse their authority to dispense these painkillers. We all know there are bad seeds in any profession. By all means, investigate and if necessary strip them of their credentials and ability to hand out addictive drugs. But what about the thousands of patients who daily deal with crushing levels of pain? If their doctor fears prescribing the drugs that will allow them to function at a level near normal, what happens to them?

I have firsthand experience with this issue. At 72 years old, I have severe pain (7 or 8 on a scale of 10). I don’t ever expect to see a time when I am truly pain free. I take Tramadol daily at half the maximum dosage. Once in a while when the pain is really bad, I take hydrocodone 5mg. I also take Robaxin, a muscle relaxant. All of this reduces my pain to a tolerable level. By tolerable I mean I can function at a near normal level and can ignore the constant pain for the most part. I am by no means pain free ( 4 or 5 on that scale of 10). If my doctor is no longer able to prescribe my 120 or so Tramadol doses a month then I am in real trouble. Texas, where I live, just elevated Tramadol to a schedule 4 drug. In the past, it was not a controlled substance. It is now. Now my doctor has to be very circumspect about dispensing my needed medications. God forbid I become addicted to pain-killers! Yeah right. At 72, I am more interested in quality of life than I am about becoming addicted or dependent.  Actually, I have no difficulty going completely off pain-killers for extended periods. I am reminded of the time when my grandfather was dying of cancer. He was on massive doses of morphine, One of his nurses took the attending doctor to task. How could he risk making an addict of his patient? The incredulous doctor dismissed her and rightfully so. Addiction was a moot point. For those of you who are fortunate enough not to have experienced chronic, severe pain I say God Bless you. I hope you never do. But don’t allow the meddlers in Washington or in my case Austin to cause those of us who do live with chronic pain any more discomfort than necessary. I have a moderate background in pharmacy and clinical pharmacology. I am by no means an expert but I am familiar enough with the drugs I take to know the risks, interactions and side effects. I understand the risk vs. benefits question. I do not need some distant government minion getting between me and my very capable doctor.

Make prescription pain-killers hard or impossible to get and watch the clinical depression and suicide rates go up.

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