By Rick Carlson
As a public safety professional, I see firsthand the damage that opioid abuse is doing in the lives of its victims and our communities.
As the husband of someone who suffers from severe, chronic pain, I am also witness to the consequences that our response to this crisis has brought to those afflicted by debilitating pain. For these people, our response has taken hope and opportunity, and replaced it with fear and stigma.
This was acknowledged in a report prepared in 2016 for the Centers for Disease Control and Prevention by a consulting company it utilized. The report warned that “Pain patients who have relied on these drugs for years are now left with little to no pain management options.” It continues: “Chronic pain is already stigmatized. Now chronic pain patients face the stigma of addiction, even when they are using opioids responsibly for pain management.” According to figures released by the Washington state Department of Health, the addiction rate of chronic pain patients who take opioids is low, running approximately 8 percent.
We’ve been inundated by stories of the damaging effects of opioids, rarely hearing of their positive benefits. I’ve known my wife for 17 years. In that time I’ve seen an athletic woman who had boundless enthusiasm and energy displaced by someone who often struggles with simple, everyday tasks because of unrelenting pain. Her story is one of resilience, courage and survival that would not have been possible without God’s grace, outstanding doctors and opioids.
It’s important to recognize that opioids, when prescribed and taken appropriately, don’t get pain patients “high,” nor do they completely eliminate pain. They simply help manage it at a tolerable level, but the issue goes beyond a person’s suffering. Untreated chronic pain can lead to several health complications including depression, cognitive decline, insomnia and increased risk of suicide. Researchers estimate that chronic pain sufferers are twice as likely as the general population to commit suicide.
In 2016, a Seattle area pain sufferer named Denny Peck took his life after his clinic was abruptly shut down and he couldn’t find help for his pain. In a handwritten note he said “And all the whitecoats don’t care at all.” Pain sufferers have come to understand this sentiment far too well.
The U.S. Surgeon General, Dr. Vivek Murthy, has warned: “Twenty years ago, the medical community acknowledged that we were not adequately treating pain, but the pendulum swung too far in the direction of prescribing opioids. As we confront this epidemic, we don’t want the pendulum to swing too far in the other direction.”
Sadly, this cautionary advice has been ignored. For instance, when Seattle Pain Centers were shut down, many providers refused to help the displaced patients. Dr. David Tauben, chief of pain medicine at UW Medicine explained “What’s happened is opioid challenges frighten so many primary care people into not providing care at all.” This must change.
We must better focus our efforts on targeting opioid abuse and addiction, not deterring responsible doctors from providing appropriate, compassionate health care. The current approach of arbitrary limits and one-size-fits-all policies prevent doctors from addressing the unique needs and circumstances of individual patients. The subjective, ever-changing views on what constitutes appropriate pain care has created tremendous uncertainty, leaving doctors in fear of losing their livelihood and patients terrified of a life of misery. Pain management needs clear, compassionate, expectations that regulators, doctors and patients can all easily recognize. Pain sufferers must be given a voice in this discussion.
I am not suggesting that we back away from our efforts to fight opioid abuse, but rather offering a reminder that we cannot allow those efforts to include a disregard for those suffering in pain. Opioids have serious risks, but until science discovers effective alternatives, they must remain an option for those whose quality of life depends on them. In this battle against opioid abuse, we can’t leave anyone behind.
Rick Carlson has worked as a public safety professional for 18 years. His wife has faced the daily challenges of chronic pain for 12 years.