Prescription Opioids & Pain Management

More Health Care Talk….

The Senate returned from their July 4th holiday this week and I began to feel my chest rise with anxiety, thinking about the life changing decisions they could be making very soon. Between taking the bill to debate, to modifying with a ‘skinny’ repeal (seriously though, that name?), to a flat out rejection, I am still struggling to understand and follow the ever changing nature of what is going on with healthcare and our government.

Opioid Abuse Is Real

What I do know is that there are still some major issues relating to prescription drug abuse, particularly with opioids, across the country, that may be directly impacted by the decisions discussed above. If you are not familiar, opioids include some of the following: Codeine, Fentanyl, Hydrocodone (Vicodin, Norco, Lortab), and Morphine. While mainstream discussion of these issues may be due to the media’s recent focus on the epidemic, I cannot help but think about the prevalence of opioids and prescription drugs and the issues they have caused in the communities I grew up in as well as the medical world I am a part of due to Crohn’s. 

Illegal Use & The Nation Wide Problem 

Roughly 60,000 people in America died from drug overdoses in 2016 alone, making it the leading cause of death for those under 50, as originally reported by the New York Times. The states with the highest number of deaths include: Ohio, Florida, California, and Pennsylvania. So, I was surprised to read that Republican senators in these states voted in favor of the bill that would repeal and replace the Affordable Care Act, namely due to the fact that the repeal stands to strip funding for programs that support rehabilitation and drug abuse treatment administered in their states. Specifically, it could possibly take away all funding for mental health and addiction services under Medicaid by 2020. To put things in perspective, currently, about 1.3 million Americans receive mental health and drug abuse treatment a year under Medicaid, in large part because of the expansion of Medicaid under the Affordable Care Act.

There have been some statewide changes however. Since the problem was showing no signs of slowing down, Ohio’s governor recently enacted a limit that allows doctors to prescribe certain opioid medications for only a 7 day period for adults, with an even shorter period of 5 days for minors. After losing one of Alex’s best friends, who was one of the kindest and smartest people I’ve had the pleasure of knowing, to opioid abuse in late 2012, we see regulation like this as a step in the right direction. Nothing ever changes the fact that he is gone, but we are happy to see some better guidelines put in place that would prevent young adults from falling into addictions that can be so life-changing.

Legal Prescriptions & Use

While I know these medications, when taken by people who are legally prescribed to them for a legitimate illness, help to ease the pain associated with particular conditions, their addictive nature should be warned against, particularly for those with addictive tendencies. Crohn’s Disease is on the list of those illnesses that opioids can be prescribed for due to the fair amount of pain and suffering associated. Since being diagnosed, I believe my pain tolerance has risen to a pretty impressive level. When I first mentioned the pain I was experiencing to my GI doctor, I was offered a few different pain management options which included painkillers on an as needed basis, as well as medication to help with anxiety. Since I was already taking 10-12 pills a day while trying to figure out my best treatment plan, I began to think this was the new normal.

For people like me, these prescriptions can be common in order to help you carry on with your normal functions, actually sleep through the night, and sit through class/work without thinking about your flare. It’s a ruthless cycle of trying to treat adverse conditions with medication, each carrying their own unique side-effect. However, shortly after receiving my prescription and trying the dosage prescribed, I wondered what the vetting process was, because it seemed like they were easily accessible.

My Experiences Managing Pain

The issue I have always experienced with these medications (as legal prescriptions, mind you) was that while I wouldn’t feel the associated pains, which was a huge relief, I also wouldn’t feel, well… anything. This is the feeling that those who use opioids recreationally and without a prescription seek to achieve, but not me. I didn’t care about responsibilities, I didn’t care what I was doing at all really. I only took them a handful of times when I wasn’t feeling well, but eventually just decided to toss them and suffer through the bad days. The potential for abuse of these pain medications, in the IBD community, is substantial because for many of us, we have never experienced the kind of constant and debilitating pain that comes along with a flare, making it difficult to address.  Once a solution is found, you still want to keep taking the medication for fear of experiencing that pain again. However, the impact of not feeling anything is much greater than you think.

Don’t Get Me Wrong …

I am not saying that those with chronic illnesses shouldn’t take prescription pain medication at all, I am just warning against the high potential for abuse in the community. There are some other extremely effective alternatives you may look to that don’t have highly addictive qualities. If you do have these prescriptions in your home and they are accessible to anyone who should not legally have them, monitor them or toss them, because after seeing what they have done today to people I have known is truly terrifying.

 To Date

Today, I am very encouraged to see doctors pull back from over-prescribing opioids and consider other treatments. Doctors have an incredibly hard job and when you are a new patient, sometimes following the standard protocol seems like the best care. I have told all my GI doctors that I’m not interested in any prescription pain medication for management and they have been responsive. I really do admire all doctors. I am probably somewhat biased because I have had some awesome medical personnel that have changed my life and a few of my best friends are doctors (so proud of you guys), but I think we all need to take a hard look at the options and decide what is best for our overall health care plan before introducing these medications into our everyday life. 


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