A lot of us struggle with pain management. There are many combinations of medication, nutrition, therapy, and mindfulness practices, and we all learn what works for us by trial and error. It’s a process and not a destination; we are all continually trying to improve on our pain management regimes.

 

You’ve heard a lot about the opioid epidemic in the news lately. I’m going to give my own perspective on it, and I will preface it by emphasizing that that’s just what it is—one person’s perspective. I arrived at my position by observation and experience, not by scientific research. It certainly doesn’t make your perspective wrong if it is different from mine. I just had a friend lose his brother to an overdose; I do not negate his story by telling my own. I think, though, that we as a society are looking at the wrong issue. The pills are only a symptom of the real problem.

Some background (read: why I think I have the right to an opinion):  I use oxycodone. I have been on a minimal, stable, non-ascending dose for years. Oxycodone is meant for short-term use. The plan was to transition me to a different drug for long-term pain relief, but I react badly to many drugs, and I share genes with people who also react badly to these things. My dad, sister, and niece had gone before me in trying some of the new pain management drugs, and I did not want to repeat their trial-and-error process. I tried transitioning to another drug once, and fell into a black depression and could barely get out of bed, much less work on rehab. We stuck with the oxy. It gets it done for me, and over time I did not need more to attain the same relief. It’s my magic bullet. I supplement it with CBD oil (marijuana derivative) when it’s not enough, rather than take more oxy. Knowing that every death in the news threatens my access to the medicine I need, I clutch my refills to my chest and hiss “preciousssssss” like Gollum on my way out of the pharmacy.

Every time I hear a new news story, it’s accompanied by shrill cries of “these drugs need to be banned!” Not so fast! There is a reason these drugs are out there—they work. Nothing kills pain like morphine, Fentanyl, and oxycodone. When you shatter your entire upper body like I did, you need pain relief. You can’t ride out that kind of pain; I would have died of shock. And there’s no way I could have participated in my physical therapy without blunting the pain. I’m all for careful monitoring of outpatient use, but let’s not overdo our response to the point where we hurt people who need this medicine.

There is a huge problem with people becoming addicted to these drugs, but I think the problem is not the drugs themselves; rather, it is the expectation in our society that you have to go back to work as fast as possible—almost always before you’re ready, and some of us never get there. That needs to be okay. We have reached a point in this country where a lot of us are in make-work jobs anyway. Health care workers, firefighters, police, teachers—those are on a long list of essential jobs. Many of us are involved with manufacturing and selling things and services that people don’t really need, and marketing those products to create desire where need does not exist. Were it not for capitalism, we could simply choose to dial all that back and let people work less and use fewer resources. But that’s another diatribe for another forum.

Here, we are concerned with the fact that most of us lack long- and short-term disability coverage, and getting Social Security disability is a Sisyphean labor that never pays off before you lose your home and your dignity. We have to go back to work while it still hurts, and we rarely continue healing there. We exacerbate our conditions until we can barely get through the day. No wonder people aren’t tapering down their doses of opioids as directed. They provide a means to make it to the end of your shift without simply collapsing in a heap. We medicate the pain while the underlying condition grows ever worse, and we’re never allowed to stop and rest.

Those of us who have been near death also have an acute sense of wasting our precious remaining time. People in essential and fulfilling jobs won’t feel this way, but too many of us relate to the crew at Dunder Mifflin (The Office). That feeling of futility, of life slipping away that you can’t get back—that must be swallowed too when we are forced back to work.

There was one time when I did have to ramp up my dose of pain meds—when I took a job driving food orders for a delivery service. It was only 12 to 16 hours a week, but it was real grownup pay. Getting in and out of the car so much was too hard on my body, and I found that my medicine dose rose 25 percent and I couldn’t ramp it back down; the “work-toughening” they tout in vocational rehab is empty propaganda. In reality, I hurt all the time and always craved a pain pill. Just as I was making the decision to quit that job, I had a serious injury while working that set my recovery back many months. I’m just reaching my goal of getting back to my lowest dose, and that’s only because I refused to keep doing the thing that was hurting me. A lot of people can’t make a Plan B, and I don’t judge them for taking too much medicine.

This is my solution to the opioid crisis—let people heal. If they don’t heal enough to go back to work, let them be done. How to pay for it? Channel some of that money we spend on office workers whose only job is to obstruct our way to the disability income we paid premiums for all our working lives. Stop working us like rented mules. We don’t need so much labor; we’re not building cities on the wild frontier anymore. Let us rest, or better yet, devote our days to activity that heals us—buildup activity rather than tear-down activity (https://blogs.psychcentral.com/hidden-disabilities/2017/12/what-the-normies-dont-understand-theres-buildup-activity-and-tear-down-activity/).

That’s my take on the problem. Cull the herd of the labor force and let the young thoroughbreds carry the day while those of us whose racing days are over enjoy our pasture. We gave it our best; let us be. I suspect that many of my readers with pain management issues may have perspectives of their own to share.