Prince: Chronic Pain vs. Pain Pills, Big Difference

By Jeralyn, Section Crime Policy
Posted on Sat May 07, 2016 at 09:50:00 AM EST
Tags: pain medicine, chronic pain (all tags)

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Lorraine Berry at Raw Story writes an excellent op-ed: Chronic Pain killed Prince, not pain pills.

Prince was not addicted to pain medication. Prince had a medical condition — chronic pain — which is criminally under-treated. It is also a medical problem that is more likely to be reacted to with stigma and condescension, even challenges about the patient’s moral character, or, if male, masculinity. Pain is still the condition that we treat by telling its sufferers to just “suck it up,” or “maintain a stiff upper lip,” or to stop acting like a “wuss.” And yet, when someone dies from complications of the disease — for that is what chronic pain is — we react with shock and pity and anger that the person died from a drug overdose. Some outlets make money off our confusion about overdose and medications and our fascination with drugs.

[More...]

Chronic pain management requires, in most cases, the taking of strong, often-opiate based medications. ANY patient who takes these drugs on a daily basis will become “physically dependent” in a short time. Physical dependence is not addiction. Diabetics are physically dependent on insulin, and yet we do not call insulin an addictive drug. Without it, diabetics would die. Stopping pain medication that has been used for chronic pain can kill you if it’s done abruptly. Under a doctor’s care, a change in pain medication is handled on a strict schedule in which the body is weaned off one drug in order to either start a new medication, or to determine whether the body is reacting in a different way to the condition causing the pain.

I agree with Berry. It's the war on pain doctors that needs to end, so they can exercise their judgment without fear of intimidation. Proseuctors, legislators and drug agents don't have medical licenses. They shouldn't be making one size fits all rules for how many pills a chronically ill patient is allowed to have.

Restricting pain pills leads people to more dangerous substances, not the other way around. Berry writes:

Before the media narrative of the tortured genius who abused drugs takes over the story, there needs to be a pushback. Chronic pain patients should step forward and speak of their own experiences of living with the condition, and the constant barriers that are being thrown up to treatment. The latest obsession with white kids using heroin is stigmatizing those with chronic pain. Chronic pain kills. It killed Prince. It’s time to talk about it.

Baby Boomers get this. They aren't turning to heroin, but to marijuana, which also relieves pain. Here's a news video from last week on a local Denver station as to how many more seniors are using pot -- not to get high, but to relax, get relief from the pain and sleep easier.

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Prince: Chronic Pain vs. Pain Pills, Big Difference | 8 comments (8 topical)

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My mother has chonic, agonizing pain (5.00 / 2) (#1)
by Mr Natural on Sat May 07, 2016 at 12:21:22 PM EST

As she neared eighty years osteoporosis began taking its toll. The vertebrae in her spine began cracking. Over radiographs, her spine doctor told me they were becoming like eggshells. She has undergone five kyphoplasties, relieving only the agony component. The pain remains, insistent, always present. She rolled over in bed one day and fractured her sternum. No kyphoplastic-like procedure for that. So, more agony, agony tied to every breath. Don't even think about coughing tied to her lung condition. She has always been responsible, used the minimum opiates necessary because she wants to stay alert, read the New York Times and New Yorker, email her remaining friends, and tend to her Tibetan Terrier genetics database.

She can no longer live alone so we moved her to my sister's house in California. Pain scrips that her Michigan doctor wrote for months at a time are limited by some aspect of California regulations or interpretation to 7 or 10 days. More doctor visits, more stupid questions to mollify the puritans and policy prigs and drive up the cost of Medicare.

This lowest common denominator b/s has got to end. We cannot continue treating everyone like a criminal.

: Very sad (5.00 / 1) (#6)
by CaptHowdy on Sat May 07, 2016 at 04:14:38 PM EST

I'm sorry to read this.

: The lowest common denominator ... (none / 0) (#7)
by Donald from Hawaii on Sat May 07, 2016 at 04:21:35 PM EST

... is what prompted the feds to crack down on Actifed, a very effective decongestant and allergy medication that had as its primary active ingredients 60 mg pseudonephrine hydrochloride and 2.5 mg tripolidrine hydrochloride, which are also the primary ingredients of methamphetamine.
So the FDA and DEA compelled the manufacturer Pfizer to alter Actifed's U.S. formula, substituting chlorpheniramine maleate and phenylephrine HCl as the active ingredients. Trust me, it's really a lousy and often ineffectual substitute. Meanwhile, you can purchase the generic counterpart of Actifed, manufactured by McNeil, over the counter in Canada and everywhere else.
So, that how people who suffer from severe allergies in our country came to be considered by the powers that be as an acceptable level of collateral damage in our government's neverending War on Drugs.
We're insane.

Yes. (5.00 / 2) (#2)
by Towanda on Sat May 07, 2016 at 12:21:24 PM EST

As a polio survivor, I increasingly cope with PPS. Fortunately, I do not yet have to do meds for it.

But I had a terrible episode, a few years ago, of back spasms (owing to one leg shorter than the other), and constant pain for more than three months. I well recall the physiotherapist asking me to rate the pain from 1 to 10. I said, "ll.".

And for the first time in my life (with other chronic conditions, hospitalizations, etc.), I had to say that if relief was not found, I could not live like that.

On the upside, I gained empathy for those with chronic pain that endures not just for months but for years. I am so sad that relief was not found for Prince.

You don't die... (5.00 / 1) (#4)
by thomas rogan on Sat May 07, 2016 at 02:16:50 PM EST

People who take opioid medications in steady doses as prescribed for chronic pain do not die from taking the usual prescribed dose.
People with pain who take opioid medications and develop the disease of addiction, with associated ramping up of doses, often die.
Don't be like the people scared to say "Voldemort", because by focusing on "chronic pain" you only increase the stigma of persons with addictions.

28 years ago, just prior to being diagnosed ... (5.00 / 3) (#5)
by Donald from Hawaii on Sat May 07, 2016 at 03:55:44 PM EST

... with Hodgkin's lymphoma, I was in excruciating pain because unbeknownst to me, tumors were pressing on several cervical nerves in my neck. The initial speculation was a pinched nerve, and I was prescribed vicodin, to be taken in measured doses. But while the prescribed doses alleviated the pain to a manageable level, it didn't eliminate it entirely, so I began increasing it on my own and soon settled into a wonderful, beautiful haze that was almost heaven.

To make a long story short, I overdosed and woke up in the hospital, having had my stomach pumped. I was still in recovery / mourning over a divorce, and I was asked if I had contemplated taking my own life. That scared the daylights out of me, and at that point I refused all opiate-based meds henceforth even though the pain had rendered me essentially dysfunctional. It also convinced my doctor to step up her own game and quickly get to the bottom of my ailment, and within two days she confirmed that I had a lymphoma. I had surgery the following day.

To this day, I have a phobia about opiates and won't touch them, because I remember just how easily I had once strayed from the prescribed dosage without even thinking about what I was doing. That said, my experience with them is uniquely my own, and I wouldn't use it as a basis for judging how others deal with pain themselves.

Aloha.

Well... (none / 0) (#3)
by MKS on Sat May 07, 2016 at 01:04:47 PM EST

The U.S. consumes such a large percentage of pain medication worldwide. And we have an epidemic of heroin use that often stems from prescription drug use.

Big Pharma has pushed pain killers. Doctors gave out prescriptions indiscriminately. Can the backlash go overboard/ Sure. But there is large problem with abuse of prescription pain killers.

: Agreed, (none / 0) (#8)
by KeysDan on Sun May 08, 2016 at 02:52:55 PM EST

but it is apparent that both health care professionals and patients need to strike a better balance. Opiates are, in most cases, effective pain killers. And, true, their medical use is often not well managed, and even abused. With a serious consequence of heroin use, for both street accessibility and being less expensive.
However, some physicians have become so reluctant to prescribe opiates owing to concerns for patient abuse and regulatory scrutiny. A common alternative for pain relief has become NSAIDs (non-steroidal anti-inflammatory drugs, such as Aspirin, Tylenol, Advil, Indocin).
And, NSAIDs are not without their own dangers, particularly for control of chronic pain. G-I tract problems; and even more seriously, increased blood pressure and kidney failure owing to reduced blood flow to the kidneys. Considering the volume of use, NSAIDs can cause wide-spread health problems. Aspirin works against blood clotting so it does bring some protection against heart attacks and stroke. But, of course, it brings with it, the problems of gastric irritation.
Patients, too, can become so concerned by the potential for opiate addiction, that they may deny themselves the comfort afforded by these drugs. So much so, that hospice patients, or others with end-stage sickness, may refuse opiates and suffer pain for fear of becoming addicted.