Over the next few blogs, we’ll be sharing a series of stories of people whose pain became so severe after the CDC “guidelines” were released and the States rushed to enact even tougher laws in an effort to show “progress” towards curbing the heroin crisis, causing a chain reaction of media hype meant to stigmatize and further antagonize chronic pain patients. This, along with attitudes from some physicians that regardless of whether the patient will decline, opioids will be reduced significantly or discontinued all together due to the government’s new opinions and instructions on opioid treatment for long-term use.
For many people, they know what type of pain they were in prior to the implementation of a pain management plan consisting of opioid treatment in conjunction with other modalities which was working nicely for them. For the majority of these patients, the pain never “goes away”, it just gets tolerable. Their lives changed in that their pain was under control and they were able to lead a semblance of a normal life. but since the passage of the Guidelines and the doctors’ reaction thereto, they are now left to decline with certainty, for no medical reason, but solely due to the passage of the CDC Guides. Unfortunately, many of these patients were abruptly discontinued from their pain management plan which worked successfully for them for years and years, 8 years or more.
When the patients are discontinued from opioid treatment, the damage begins very quickly. Regardless if you want to call it “addiction” or “dependence”, the outcome is the same. Whenever someone has been on medication for 8 plus years, their body will undergo some changes when the medicine is abruptly discontinued. Some will develop severe symptoms causing them to be gravely ill and will have much difficulty at home, sometimes without any help at all. Doctors, many times, due to fear of governmental remedial measures, are afraid they will run into “trouble” with the DEA or other governmental agencies, unless they cut their prescribing practices, either discharge some patients or cut back on every patient. Therefore, for the chronic pain patient, once a doctor decides he no longer wants to prescribe opiates for a patient who has been on opiate treatment for an extended period of time, is suddenly without a doctor and has been “red flagged” in the doctor’s chart, life gets complicated. The patient has a hard time finding a new doctor. And the cycle goes from there.
The CDC has acknowledged an increase in suicides due to pain. The link is the National Pain report’s story on it, and confirmation of our first of several upcoming articles regarding people who chose suicide as their only means of ending the pain that was making their lives miserable and not worth living. Many people have their own opinions about suicide. However, no one can see pain. No one realizes that behind that smile is a lot of pain. No one realizes when these people are alone they do not hide it; they are in agonizing pain. For some, though, reality for them is that there is nothing that will help their pain and enable them to lead a somewhat active life except opioid treatment. Opioid treatment will allow them to become more active, which will prolong or decrease their chances of decline due to inactivity associated with extreme pain. With no light at the end of the tunnel, patients elect suicide as a way to end their pain. Also adding to the suicidal ideations is depression, anxiety, and a host of other ailments that add to an already incredibly bad situation, which will be discussed further in future blogs.
At the end of it all, it is the doctor’s responsibility to do what is right for the patient. Treatment plans must be individualized for each patient to ensure the highest level of functioning. And when the benefits outweigh the harm, opioids should be used to decrease the risks of avoidable decline and the conditions associated therewith.