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A Responsibility to Find New Pain-Relief Methods in Midst of the Opioid Crisis

A Responsibility to Find New Pain-Relief Methods in Midst of the Opioid Crisis

If you’ve ever found yourself in the unenviable position of pointing to a number on one of those pain scales with the cartoon faces, you know that’s not what pain looks like. You know pain looks like landscaping managers, public accountants and mail carriers gritting their teeth and doing exemplary work even when their body doesn’t want to let them.

You probably also know that we — the people of the world and in particular the nations that claim to lead it — need a brand-new approach to relieving human pain. Our existing solutions pack our prisons, sentence nonviolent offenders to life and exacerbate one of the worst and most avoidable tragedies in recent memory.

The State of the Opioid Crisis and What Comes Next

The current Secretary of Health and Human Services, Alex Azar, said in late 2018 that America appeared to be turning a corner on opioid deaths. He cited figures that do, indeed, point to a minor drop-off in opioid-related fatalities. There are reasons to be only cautiously optimistic — such as the small timeframe Azar’s data draws from — but it’s still encouraging to see such signs. The question is, what do we do next?

One of the reasons why opioid deaths may be in decline is that doctors are more reluctant today, with media and regulatory attention, to write prescriptions for opioid-based pain relievers in the numbers previously seen. It’s not debatable that opioids are habit-forming. It’s also well-known that when opioid-based pain relievers aren’t readily available, patients and abusers alike sometimes seek cheaper illicit alternatives that do the job nearly as well, like heroin and fentanyl.

Between 2011 and 2012, we saw another plateau in drug overdose deaths from prescriptions. It was followed swiftly by an explosion in fatalities from fentanyl and other synthetic black-market opioids. We’ve made a small amount of progress by turning the regulatory spotlight on doctors and pharmacies. However, most of the rest of our apparatus for fighting the opioid epidemic doesn’t go nearly far enough.

Public Health Institutions Point the Way Forward

When some U.S. states chose to expand Medicaid and Medicare — social, community-owned health care programs — to cover the cost of drug abuse treatment and prevention, those states saw a corresponding drop in opioid-related deaths.

Nothing about the satisfyingly scientific research done on this subject should take anybody by surprise. Community-owned health programs greatly expand access to life-saving overdose drugs as well as dependency and general health programs for those who need a new way to live a full life even with chronic pain.

Look at it this way: The Affordable Care Act was a public investment in private health insurance companies. It remains as incomplete, selectively helpful and controversial today as the day it became law.

Medicare and Medicaid are public investments in community-owned and government-facilitated health care systems. These programs are still wildly popular and successful, more than half a century after their implementation. They have a vital role to play in helping connect people with pain relief methodologies and medications that work, don’t result in dependency and provide a more confident path forward for those in recovery than any stint in prison ever did.

A New Way Forward Must Include Alternative Medicines

Who lives with chronic pain? As mentioned, anybody, from any walk of life, can find themselves at the mercy of debilitating and recurring pain. Which conditions make this more likely? It’s things like intensive surgeries, nerve damage and a dizzying variety of bodily injuries.

That makes it important for everybody to remember that ill health — and a lifetime of pain afterward — can befall us or somebody we love at any time. The first thing that needs to change about how we manage pain, and health in general, is how we talk about it. If there’s a more social cause than health care, it’d be hard to find.

As a nation that prizes competition and innovation perhaps above all else, we owe it to ourselves to explore every possible avenue when it comes to the cessation of chronic pain and confronting the opioid crisis in a decisive, lasting way. Here are some places to start:

  • Combined with regular light exercise, meditation apps have shown a great deal of promise in helping chronic pain patients achieve relief throughout their days.
  • An ever-larger body of research points to THC and other compounds in marijuana as credible pain-relievers and anti-emetics, meaning they could be perfect for those suffering from chronic pain and other complications of cancer treatment.
  • The opioid dependence that over two million Americans are now facing can partially be attributed to overzealous doctors and hospital staff. It is natural to want to ease somebody’s pain as quickly as possible, but health experts have identified behavior training as another essential component in a holistic answer to pain relief that doesn’t worsen the opioid crisis.

If we can’t find our way, collectively, to more social, community-owned health care institutions, and we don’t wish to make previously illicit substances legal, and we’re skeptical about meditation and yoga, what else is there?

Science and pseudoscience. Relaxation and psychological therapies have shown signs of improving the body’s functionality and even helping ward off pain. Many people swear by acupuncture and aromatherapy for the same reasons. Whether you lean spiritually or prefer a skeptical approach, it’s clear that a decisive end to the opioid crisis requires that we change how we think and talk about pain and how we dispense health care. We must leave no stone unturned in good-faith investigations of alternative treatments that show potential.

What most of our failed pain-management and drug-control strategies so far have in common is that they put capital first. Putting people over profits — be they for pharma or private prisons — is the only thing that will help bring this particular chapter to a close.


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Kate Harveston is originally from Williamsport, PA and holds a bachelor's degree in English. She enjoys writing about health and social justice issues. When she isn't writing, she can usually be found curled up reading dystopian fiction or hiking and searching for inspiration. If you like her writing, follow her blog, So Well, So Woman.

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20 thoughts on “A Responsibility to Find New Pain-Relief Methods in Midst of the Opioid Crisis

  1. I think that alternative therapies show some promise but they aren’t a complete solution either. I had chronic lower back pain for 20 years. I was one of those people that just gritted my teeth and powered through but I was miserable. Tried almost every therapy out there from opiates to yoga to acupuncture to exercise, with varying levels of success. What helped the most? Finally get an MRI and being diagnosed with osteoarthritis. One pill per day aimed at this has dramatically increased my mobility and quality of life.

    Unfortunately back pain especially is an epidemic that has no silver bullet solution.

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    • One of the best things doctors can do for pain sufferers is actually listen, investigate, and find out what’s going on. Having people tell you that you’re experiencing something normal or that you’re not really experiencing anything (ie calling you crazy) when it’s obvious that something is very wrong, is terrifying and adds anxiety onto an already difficult situation.

      Plus, they can often treat the underlying disease, even if imperfectly, and alleviate some if not most of the suffering without pain meds.

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  2. Something I’ve been wondering about is why it is that the most effective pain killers are addictive and have recreational potential. Is it just bad luck that the most effective pain killers we’ve found happen to have these properties, or is there some logical reason why we should expect this?

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    • As I recall, relief of serious pain requires drugs that bind to opioid receptors in the brain, spinal cord, or peripheral nerves. The most effective pain-relief drugs use the same set of receptors as endorphins, hence the potential for recreational use. Finding alternatives that are both effective and lack recreational potential is an active research area. If someone comes up with one, they’ll get very rich.

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      • At least, the opioid receptors seem to be the only avenue of access we’ve found yet where we can deliver a drug.

        In general I guess, if a drug is powerful enough to handle real serious pain, it’s probably going to handle serious emotional pain as well as serious physical pain. Which seems likely to mean it’s addictive and has abuse potential.

        Maybe instead of / in addition to focusing on “no recreational potential” a useful avenue of research would be things like, lower severity and likelihood of overdose at recreationally realistic doses, less long-term health damage from chronic use, etc.

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  3. While this is a very nice piece and well-intentioned, as someone who actually has chronic pain from autoimmune disease it sets me on edge when people tell me to meditate and exercise, and/or ask “have you tried cannabis (or turmeric, or flaxseed, or a Thermacare heat wrap, or whatever-it-is)”

    I separate the intent of this piece from those who say that as a default position, but if you’re reading this piece I humbly suggest it’s not necessarily a welcome thing to say to your friends/relatives who are in chronic pain.

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    • As a fellow person with autoimmune disease that causes pain, I agree completely.

      It would be much more useful to say something like “I’m so sorry you’re going through this. Is there anything useful I can do?”

      That said, as such a person, it drives me nuts that the healthcare system is totally on board for throwing as many drugs at me as I could possibly want with merely a few additional hoops … mostly because those drugs *aren’t* that helpful for me except as a failsafe, so I exhibit the opposite of “drug-seeking” behaviors, which is stupid since if I was one of the people they helped more, I’d damn sure be seeking them…. and yet all the stuff I actually find infinitely more helpful, they make onerously difficult to get them to pay for.

      I mean, I have the money to pay for it, and I have my lifetime subscription to the one program I’ve found that’s actually lessening my pain by giant leaps and bounds compared to anything else….

      But it pisses me off on behalf of other people who have the same issues and might find the same help, and get tons of pressure, economic and otherwise, to stick to drugs.

      I find if I look at these “alternative medicine rah rah” pieces as “stop elevating drugs over everything else” instead of going to the place of thinking about all the people who say “have you tried X?”, I find them welcome rather than irritating.

      Your caveat is wise, though.

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      • I didn’t take this as an alternative medicine rah-rah piece at all but I did just want to mention that since so many people have said those things to me. I’ve seen enough people on tons of medication that I agree it’s definitely a thing where many people are handed prescriptions they don’t need or even want and totally fine to present alternatives (even if those alternatives didn’t happen to work real well for me personally).

        I’ve had a different experience in that I couldn’t get any doctors to believe anything was wrong with me. So it took me years before I got to the point where they were offering me anything other than an eyeroll and anti-depressants. The hoops I’ve had before me involved more “convince me you’re not crazy before I do any investigation” and not “convince me you need/don’t need pain relief”. I haven’t had that situation arise yet and I appreciate hearing your experience, thanks.

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        • Weirdly, I was getting “well here are drugs so stop complaining that there’s some underlying problem and something consistently wrong”. So, like, tons of drugs but no interest in solving the problem or identifying the causes. For years. And since most of the drugs weren’t of any help, and the ones that were knocked me over and made me non-functional (hello vicodin, my trusty 4 times a year failsafe), I just kept being in pain the vast majority of the time.

          I had chronic pain that was being treated like – and identified as – a series of completely unrelated acute pains. As if I “just happened” to constantly be injured for months because of trivial things.

          Looking back, it’s pretty weird… only when I was able to really identify that pattern and talk to my (then-new) GP about that point-blank did anyone start getting on board with the chronic autoimmune illness thing.

          Turns out I have a half-dozen of them.

          Also turns out (super-weirdly) that the drugs that helped *most* with the pain were classed as anti-depressants *even though I am almost never depressed*. Well, those and the antibiotic that suppressed the immune reaction in my pores so I don’t get giant boils anymore (also not being used as classed, it isn’t killing any flora, just my own immune reaction). Because the body is a strange and wonderful thing and drug classifications are super-narrow.

          Sigh.

          It’s all so stupid.

          Very much agree with your comment, above, that doctors who actually listen and want to understand and solve problems are key to pain management. My then-new GP is now my beloved and trustworthy GP who reads the newest medical research on my conditions regularly and discusses her reading with me. (this only takes about 5 extra minutes in an appointment – more time than that for her reading obviously, but she just sees that as part of being a doctor) She also, non-coincidentally I imagine, has a completely full roster, no ability to see people for urgent care stuff, and no ability to accept new patients. But she’s a damn fine patient advocate / care manager & I see her every 3-4 months to figure out how to keep moving forward. Which is a nice change from seeing her every 3-4 months to figure out how to fracking keep my head above water, but both seem to be rare in the world of pain management…

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          • I’m really glad your doctor is good, though it seems like it was an ordeal to finally get one who’d listen to you.

            In the last couple months, I’ve had a medium-level health scare. It wasn’t a pain issue, so not directly relevant to the topic at hand (and thankfully, everything *seems* okay now). But it seemed like the doctor listened to me only partially and latched on to a few key words I said without actually listening to other things I said. That’s partly due to my habit of adding the tag line, “then again, it’s possible I’m just making this up.” Anyway, it would have been nice if he had listened to me more.

            I also wonder if he would have listened to me as much as he did had I been a woman or not white. I know a woman who a few years ago had some recurring pains and her doctor (also a woman) didn’t seem to treat it as a big deal, but it turned out to be gall stones.

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            • It’s NOT due to that habit, Gabriel. They treat everyone like that. I seriously think their policy is to send people away a certain number of times and then if you keep coming back, something may actually be wrong. I’m sorry you had to go through something like that.

              But yes it’s way more a problem for women. The doctor left his computer open one day and he put me down as having psych problems and attention seeking. When he finally diagnosed me with something after a year of having me keep diaries and stuff like that, he was so shocked (he hadn’t even bothered to look up my test results) that he couldn’t even hide it.

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                • No, and then he was apparently embarrassed or something, because he got up and said “well I’m gonna let you follow up with your eye doctor” and he got up and all but ran out of the room. No referrals, no information, no follow up testing, no treatment plan, nothing. Then when I went back to him after doing my own research to demand a couple of referrals, he was super suspicious of me and eventually asked in a very condescending way “Why do you think you have this disease? Did you look it up on the internet?” He still hadn’t bothered to look up my case history before I went in there, because he’d decided I was crazy I guess and that was all he remembered about me.

                  But honestly none of that was particularly new, as I’ve been going on for 25 years with these weird symptoms and every doc I’ve seen up until very recently has been some variation on that theme.

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          • Ah, I gotcha. I can completely see how that could happen – that rather than them saying “there’s nothing wrong” they might say instead “have some meds”. Same issue, just different solution. No interest in solving the problem or identifying causes. They tried to put me on the anti-depressants too but they made me super dizzy (which I already was, anyway, so I couldn’t function)

            Your experience is identical to mine. None of this stuff could possibly be related. In my case it was a supposed series of injuries, rashes, a heart problem, allergies that were nothing like allergies, and “you’re just getting old, it’s perimenopause”. And then the test for it was SO easy – a simple blood test they could have done at any time. It’s inexcusable as widespread as AI diseases are that all women aren’t checked for them every so often.

            Same experience as well with the anti-depressant/anti-anxiety medication. I was given Ativan, which helped with this severe dizziness I was experiencing, and so the doc (perhaps understandably) decided “panic attack”. But once they found out I had Meniere’s Disease, well, Ativan is actually the treatment for that. It was coincidental that it helped with my dizziness at the same time.

            I’m really glad you found someone you like. That’s priceless.

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    • I used to be one of those people who believed really strongly in “alternative” approaches to medicine, and I still try to keep an open mind about them. I’d like to think I didn’t preach it, but maybe I did.

      At any rate, I don’t anymore. I’ve known several people who have pointed out to me how it feels to have people who don’t know what it’s like (which, thankfully and knock on wood, I don’t and haven’t so far) tell them how to deal.

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      • Me too – especially exercise. I took having a normal resilient body for granted for sure. I always thought “if I ever get sick the first thing I’ll do is get in fantastic shape and then staying healthy will be my full time job”. I quickly found out that things change when you’re sick and ended up not able to walk for 10 weeks because I overdid it and hurt one of my joints really bad. :/ And that doesn’t even take into account pain, exhaustion, dizziness, nausea, etc that goes along with many illnesses. I realized pretty quick that some of the judgements I’d made about people “not taking care of their health” were completely ridiculous and uncharitable in the extreme.

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  4. I had serious surgery 3(ish) years ago. They sent me home with serious pain meds, which I needed for 2 or 3 days afterwards (then switched to more OTC stuff).

    But they gave me like 20x more meds than I used. Even at the time I thought it was somewhere between overkill and a bad idea.

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  5. Medicare and Medicaid are public investments in community-owned and government-facilitated health care systems.

    1. Medicare and Medicaid are government-run insurance programs. In no way shape or form can anyone describe them as “investments” based on the mainstream definition of the term.

    2. Aside from the VA, the U.S. government neither owns nor operates health systems. Health systems describe healthcare providers, usually those own and operate acute care hospitals.

    3. “Community-owned” is socialist nonsense. This is the kind of language trickery that was all over Matt Bruenig’s rainbows and unicorns attempt to make a case for a U.S. “social wealth” fund, which in reality is really a sovereign wealth fund since the assets are technically owned by the sovereign government. While the “community” benefits, the idea that the “community” shares any of the rights/privileges/responsibilities associated with ownership requires a more vivid imagination than I have.

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