Everyone has a story like this, when you tell them you take pain medication for chronic pain: an uncle, or a cousin, or the friend of a friend got addicted to pain pills, or they started with pain pills that they stole from their grandma’s medicine cabinet and upgraded to shooting heroin within, like, a month, or they have pain that they are obviously exaggerating so they can get pills.
And then I wish I hadn’t told them.
Some people ask, “Aren’t you afraid that you’ll get addicted?”
And then I say, “Yes,” and also wish I hadn’t told them.
I am always afraid that I’ll get addicted. There’s a voice in the back of my head that starts to whisper every time I open the pill bottle -- hell, any pills at all, even the anti-depressant that I take. You shouldn’t NEED these, it says. Strong people do not need pain pills. Strong people do not need pills at all. They just take it.
I spent years “taking it” thanks to numerous health problems, and now I wish I could get those years back somehow, since I am much happier now that I’m in less pain and am not suicidal.
The years I spent taking the pain from one condition in particular -- suffering through the pain caused by fibromyalgia -- were not my best. One of the things that people who do not have chronic pain do not understand, on a physical level, is that chronic pain wears you down. It changes your personality; some studies have even linked undertreated chronic pain to major changes in the brain.
But try telling any of the above to people who do not understand what it’s like to live with pain that does not end. I’ve tried; a precious few try to really “get it.” Some of those who do not invariably say things like, “But it seemed like you were doing JUST FINE back then -- you were happy whenever I saw you!”
Here’s a partial list of the things that they didn’t see: my taking 3-4 full days off per week to recover from the things that filled my “on” days; my switching to part-time status so that I could finish my undergraduate degree; my time spent alone either trying to sleep off the pain, or crying in bed from the pain. That last one made up the vast majority of my time before proper pain management came into my life.
The hairline fracture that I sustained from one of my (many) unfortunate falls due to crappy balance (thanks, cerebral palsy) seemed so small for something that caused so much pain. The fracture was nestled right between my left thumb and forefinger -- and since it was a hairline fracture, there wasn’t much that could be done at the campus health center other than charging me $38 for a sprain bracelet, giving me a tetanus shot since I’d landed on pavement, and sending me on my way.
Four days later, I was back at the health center and in urgent care -- this after having left my seminar class while sobbing in distress, even though the seminar professor was not happy about my departure, and had encouraged me not to leave in the middle of class because it was “disruptive.” What was disruptive was my teeny-tiny fracture, which was making my entire arm feel like it was being eaten by a horrifying hell-beast over and over again.
Combined with the day’s fibro pain, which seemed akin to stones being piled on top of my shoulders and upper back, it felt almost unbearable. I would have happily welcomed another tetanus shot and its muscle ache-inducing properties as respite.
Thankfully for me, it was a surprisingly slow day in urgent care, and I was able to see a sports medicine doctor; other than the doctor’s insistence on bending my thumb the wrong way and making me yelp from the searing pain (for the benefit of the medical student who sat in on our appointment) there was little out of the ordinary.
That is, until the doctor wrote me a prescription for generic Vicodin.
Even in my tear-streaked and profoundly uncomfortable state, I expressed my concerns about the prescription: “But that’s addictive, isn’t it?”
The doctor gave me a long look, and then said neutrally, “Not if you use it correctly in managing your pain.”
The Vicodin worked for the hand and arm pain until the fracture healed, but more surprisingly, it also helped to tone down the fibromyalgia pain as well. A few months later, after I’d run out of the pills that the sports medicine doctor had given me for my hand, I brought up this amazing discovery with the rheumatologist that I was seeing for fibro pain management.
The pills were capable of taking my pain level down from a 6-7 to a 2-3, which was an amazing difference -- like going from a raging bonfire everywhere on my body to glowing coals and ash. The pain was still there, but markedly less so.
“Yes, Vicodin tends to help with fibromyalgia pain,” she said, before writing me another prescription for the generic version.
Sometimes I wonder how I could have been so oblivious to the fact that proper treatment for pain is, well, not a bad thing. One piece of this puzzle: the media, at least in the U.S., tends to focus on pain pill use, abuse, and addiction by people who do not have chronic pain.
Even if these stories offhandedly mention that these pills are used to treat pain in people whose physical pain does not go away, however, the stories of those who use pain medicine responsibly -- or, worse, accused of drug-seeking behavior because they need certain types of pills for chronic pain -- are usually overshadowed by the “How can we prevent pain pill addiction?” concern, instead of asking, “How can we treat chronic pain more effectively?”
My worries mostly stemmed -- and still do -- from my complicated family history of alcohol addiction. Several members of both my immediate and extended family have had decades-long problems with alcohol, and I was, for a time, convinced that I would go down the same path no matter what I did.
I don’t drink and have never used drugs recreationally -- both of which sound really weird, I know -- but the thought of becoming addicted to any substance was scary enough that I eschewed comprehensive pain management (to my own detriment) until a relatively small injury broke me.
But the media attention on “OH NO ADDICTION!!1” on the topic of prescription painkillers certainly didn’t help, either; in my case, combine an anxiety disorder, chronic pain, the experiences of growing up in an alcoholic family, and many media articles to the tune of PAINKILLERS ARE ALWAYS ADDICTIVE and you’ll get a person who is desperate enough not to become a statistic that she’ll just bear with the pain whenever possible.
Writing this also feels like a justification and a disavowal at once: Here’s why I can take pain pills, because I’m not like those other people who get addicted. Am I concerned about people who are addicted to pain medication?
Of course, and I think that people who have chronic pain and are addicted often get the short end of the stick in these discussions, since there are hundreds more news items about people without chronic pain who are looking for their next fix of pills -- which then serves as a convenient excuse to be suspicious of pain patients who actually need those medications (for more on this, see this piece on the addiction news website The Fix).
And even though I still try my damndest to be responsible when it comes to using pain meds, that voice is there in the back of my head: How do you know you’re not just doing this to get blasted? You might be one pill away from addiction, you know. Pain control? HA. If you were stronger, maybe you’d be able to handle it without drugs. Control YOURSELF.
There’s an important distinction that a lot of people miss when handwringing/concern-trolling over but won’t you get addicted because pain pills are dangerous stats: These pills can be dangerous for some, but they allow other people to function.
Occasionally, I catch myself feeling sad or angry about all of the time that I spent being so hard on myself to just deal with the pain on my own, or the days I spent in bed crying and wondering whether dealing with the pain would ever get easier. But the thing is that proper pain management has given me my life back, and instead of feeling sad for the past, I am actually excited about my future.