There's a "prescription drug abuse summit" here in Portland today (Monday).
I only know about it because there was a big article in the local paper about a guy who developed chronic pain after a mugging, got addicted to his pain meds and then turned to heroin when he could no longer get the prescriptions.
Don't get me wrong -- I know that some people do abuse their prescription medication. I know that some people exaggerate or lie about their conditions to get prescriptions, either to abuse the drugs themselves or to sell them. Or both, probably.
But I also think there are way too many people out there who are suffering in pain needlessly because doctors are afraid to prescribe meds that might catch the attention of the federal and state agencies who monitor these things.
My copy of Melanie Thernstrom's The Pain Chronicles (I know -- I keep talking about this book, but it is so well written and full of pertinent facts!) should arrive on Monday or Tuesday, and I had to return the copy I borrowed from the library so I don't access to the statistics she cited.
But it was something like only 6 percent of people who reach age 30 without developing addictions to alcohol, cigarettes, illicit drugs, etc., are at risk of becoming addicted and abusing properly prescribed pain meds. It was an even smaller percentage who jump from their prescription drugs to abusing street drugs.
It's true that just about anyone who takes opioid medications for lengthy periods will develop a physical dependence and need to wean down to limit withdrawal symptoms. But that's also true of anti-depressants, Prednisone, and probably lots of other medications I'm not thinking of.
When I moved to Portland in 1999, I brought, among my other medical records, documentation of my 1995 on-the-job shoulder injury that required two surgeries and led the state of Washington to declare me permanently partially disabled with limited range of motion, limited strength and chronic pain. The first thing I was told by the doctors I tried to set up as my primary care docs was, "I don't prescribe pain medications."
OK ... I wasn't asking for any -- I was simply giving them my medical history. And it's not like they required any kind of proof or testing before prescribing my requested allergy, asthma and migraine medications!
I was, however, a bit relieved that I had stockpiled pain meds after my second surgery. Because while I didn't take Vicodin on a daily, weekly or even monthly basis, I did have pain flares periodically and I had learned the hard way about how pain spirals out of control if it's not treated properly before it gets really bad. (The difference between my first surgery, when the nerve block failed and the surgeon gave me inadequate post-surgery pain meds, and my second surgery two years later, with a successful nerve block and a doctor who prescribed adequate strength and quantity of pain meds, was amazing. But apparently very textbook because there are lots of studies that document that process. (That first shoulder surgery was also when I learned that I would never again tolerate a doctor who didn't have good communication skills and a willingness to answer my questions fully.)
I consider myself lucky that I have a good relationship with a good doctor, who trusts me to take medication appropriately. I apparently also don't set off red flags for her, since I know she has refused to prescribe pain meds for some other patients whom she believes are using them inappropriately.
But there are a lot of other people out there who are suffering needlessly, not because they abuse their meds but because their doctors are afraid. Writing too many narcotic prescriptions garners attention, and sometimes investigations. Licenses can be lost, and reputations are easily tarnished even if they are ultimately cleared of any wrongdoing.
I remain unconvinced that making it harder for people with pain to get pain meds (by increased monitoring of prescription medications, the goal of the "summit" here) will make a significant difference in the number of drug abusers. What it will do, and what it has done in the past, is make more people suffer.
I don't feel like I am expressing myself here as well as I'd like. The downside to needing to post daily means that I feel pressured to get the post out quickly rather than taking an extra day or three to ponder and tweak what I'm trying to express. I do have strong feelings on the topic, mostly because I know too many people who have given up on the medical system and suffer at home.
Have a happy Monday, everyone!
3 months ago