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A Cup of Coffee – wrapping up a month long discussion on Opiates

Welcome back!  We had a very long, very intense month regarding Opiates and their effects on people both from use, and lack of use.

I would like to thank our Guest DO, Dr. Jorgensen at Patient360 for his well thought out blog and responses.  Your insight has helped a lot of our readers.  Thank you to our community bloggers for their ability to be vulnerable in the face of painful memories.  You made a difference.  Don’t ever stop telling your truth.

This writer once worked as a shelter case manager, and had a couple with two adorable children on my case load.  They loved those kids so much.  You could see it in the way they touched them, looked at them…looked at each other.  But this was a family with a mistress…heroin.   They had become addicted to heroin at a college party, and were desperate to kick it, for the sake of their small children. 

One day, they came into my office and asked how much longer it would be before they could get into treatment.  This was a question I always dreaded.  “Weeks…maybe months…it just depends.  Hang in there, ok?  It will happen for you”.   Several days later, they came to me again, this time to turn their children over to social services.  I sat there in stunned silence.  Here stood two little ones, golden blonde curls…the little boy so tiny he hadn’t yet had his first hair cut.  I felt tears stinging my eyes as they asked me to take good care of their children.  I begged them, “Please don’t do this…you don’t have to do this…”.

I waited until 5pm to call for protective services.  I truly believed they would come back.  This must be a desperate mistake, right?  How wrong I was.  I sat there all day watching their children play in the corner of my office…coloring, role playing with stuffed animals, hugging each other from time to time.  Little did they know what awaited them at the end of the day.   Their terrified screams rang in my ears for months as they were removed to go with total strangers to a world they had never known. 

I found out later that this beautiful young couple walked to the tallest bridge in Portland, held hands, and jumped off.  Welcome to addiction.  She demands your faithfulness.  Don’t make her angry.

Now…back to our blog.  Our question was:  “Opiates:  Are there any good answers?” 

Did we come to a conclusion?  Yes…we did.  These two experiences (addict vs. pain patient) are not mutually exclusive, and you cannot, and must not, forget that.  Does this patient need more supervision?  Does this patient need more medication?  Does this patient need mental health treatment?  Each patient is an individual, with personal issues that are unlike those of the next patient, and doctors need to be able to practice medicine and make those tough decisions without fear of losing their license to practice. 

Dr. Jorgensen pointed out that prescribing responsibly is an absolute must.  There is no other way to prescribe opiates now that we are down the river of darkness.   Those that aren’t abusing the medication won’t mind, and those that are abusing it can get help sooner.  Pill counts, urine analysis, and check in’s are all great ideas.  This writer appreciated Dr. Jorgensen’s ability to get into the solution, rather than just speak about the problem.

People who suffer day in and day out from chronic pain are killing themselves, both from overdose and from lack of pain control.  This is unacceptable.  The pain patient is 100% correct when they say, “I’m not an addict, so why do I have to suffer?”.   The solution isn’t to take away from those who suffer.  The solution is to protect those that would be addicts.  Too often we try and separate the two.  In my opinion, they are not separate.  Many addicts suffer from emotional pain, while folks with cancer or arthritis suffer from physical pain.  What’s the difference?  There is none.

Why we ever detached the brain from the rest of the body is a mystery…and why we continue to do so is mind boggling (no pun intended).  The body cannot determine where the pain is coming from…emotional pain vs. physical pain is often impossible for an addict to discern.  This is why they must be protected.  They cannot help themselves…physicians must help them.  Labeling them as “seekers” and putting them on the black list is less than helpful.

This conversation needs to stay in the realm of solutions, not anger or blame.  “Tell us what you need” should be the question to every addict…because trust me, they know exactly what they need.

Will spoke to this quite eloquently in his blog when he said, “it’s mental health”.  So true…and where was the mental health care when he needed it?  Unaffordable.  Unavailable.  We need to do better…for the Wills, the Jim Jones, and for the couple that jumped to their death, rather than face one more day of addiction.

One thing is for sure.  We can’t just give up.  There have to be answers that work for everyone.  Those who suffer, need not, and those that are addicted need to get the help that will put them on the road to recovery.  Walking away from this is not an option.  There is simply too much at stake.

Please join us next month as we tackle the subject “Pain vs Suffering”.  An appropriate next step in this conversation…thank you for reading us…we appreciate you.

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