Taking pain medication away from patients who desperately need it is no way to fight opioid abuse.
Bags of heroin, some laced with fentanyl, are displayed before a press conference regarding a major drug bust, at the office of the New York Attorney General, September 23, 2016 in New York City. Drew Angerer / Getty Images.
Each morning and evening I take Pregabalin, a controlled drug classified as “Class C” by the British government. The drug attempts to limit my chronic back pain. When the pain is especially bad, I turn to my monthly codeine prescription. Americans have been talking at length about the opioid crisis, which mingles rapacious pharmaceutical companies with endemic poverty and a complex and expensive healthcare system. Now the conversation is moving to Britain too, with concern people are buying codeine, tramadol and other pills online, without the knowledge of their doctors.
What’s missing from many of these discussions is the voice of people with chronic pain, those dependent on opioids at times, whose pain can be debilitating and excruciating. Without opioids, on some days I couldn’t get out of bed, the tumors in my spinal cord making it almost impossible due to the pain. Neither the US or the British healthcare system deals with chronic pain adequately. Doctors in the States hand out pills whenever requested, and the huge rise in opioid prescriptions in the UK is down to budget cuts, meaning it’s easier to prescribe some pills than get to the root of the problem, or refer someone to a pain clinic.
Addiction remains an issue, and doctors should take it seriously when prescribing. But once addicted, there is little to no support for people to get off the pills. The subject of addiction is still taboo and addiction support services are massively underfunded. But the panic over opioids is likely to spill over into the prescribing patterns of general practitioners, and people with chronic conditions are likely to be left in pain as doctors become more hesitant. Women already don’t have their pain taken seriously by doctors. And any move to lower the number of painkillers for chronic conditions would simply be an exercise in creating unnecessary pain. People with conditions that cause pain will be left to suffer, told to tolerate daily pain while struggling to work or have anything close to a normal life.
Medical practitioners can combat the aggressive marketing of opioids without causing preventable suffering among those with disabilities and chronic conditions. For example, pain clinics are currently oversubscribed in Britain, but should be invested in if patients’ welfare is of concern. Also, opioids should also not be used in isolation: taking codeine on a rough day allows me to go swimming, which in turn improves my back pain. Without it, I’d be stuck in bed, unable to move. The pills can be incorporated into a normal life if doctors are more diligent and spend more time working out how to relieve the pain in patients’ lives.
The backlash against opioids ignores the thousands of people who take them not because they’re addicted, but because they’re trapped in a battle with their own body. On the worst days, it feels as though my central nervous system is attempting to kill me. At that point, taking the edge off the pain is essential to stop me losing my mind. That’s not an unusual feeling amongst those with chronic pain. But we’re rarely represented in discussions on opioids: the focus is purely on addicts, presumably with no health problems, or people who got a short term prescription after an operation and became hooked, buying endless pills online.
But vast numbers of people who take opioids aren’t addicts: they’re just people stuck with pain that would crush their lives and leave them unable to work or socialize in the absence of opioids. If the backlash causes the number of prescriptions to drop sharply, untold numbers will be left in pain solely for the purpose of meeting numerical targets. News stories on this crisis should be more nuanced. Many opioid users aren’t addicts. They’re people who desperately need those pills.
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