Pain management may lead to opioid addiction

Everyone is addicted to something: drugs, alcohol, sex, food.  This is a paraphrased quote from our ‘all too human’ former President Bill Clinton.  He used to tell us he felt our pain, so we elected him twice.  Then we discovered he was a serial womanizer and carried on with many affairs.  He was impeached essentially over his sex life.  But Clinton understood something about the human condition perhaps because he understood addiction.

Now that President Trump has declared the nation’s opioid crisis—with more deaths every day than car wrecks and gun deaths combined—maybe something can be done to save lives.  Last year 50,000 Americans died from this addiction, the great majority no doubt slipping into death unintentionally.  But drug deaths have been going on since, well, rock and roll: Jimi, Janis, Jim, then Elvis, later Michael, most recently Prince.  Their deaths were accidental, too.  They weren’t suicidal, just abusing drugs.  They were caught in a trap.  And at least two had money to seek modern-day treatment.  They couldn’t say they had no idea they were addicted to drugs.  They knew the game, played, and lost their lives—and in so doing caused a great deal of grief to their families and millions of fans around the world.

Something for the pain

Why do some people get addicted to drugs and others don’t?  Since the days of LSD, our scientists know so much more about addiction, brain chemistry, and genetics.  Will power may be a part of the equation.  Americans have a long history of cramming that thought down the throats of our loved ones, especially the older generations to the younger.  Still every day more and more people get hooked particularly on a cheap heroin derivative.  It might have started with an injury or surgery and some very effective pain pills.  The prescription ran out in a week or so and either was refilled by someone else or the street dealers came around or were pursued.  But when the addicted start committing crimes to support their habit, everyone knows the situation is deadly serious and must be stopped one way or another.

What is a family of an addict to do?  Television shows like “Intervention” chronicles such plights.  We are allowed to see how low the addicted go, how they have their daily plans to score dope, how they search their body for a vein that isn’t blown from overuse, how awful they look, how they lie and steal and prostitute as their lives are absolutely worthless … to them.  That’s the addiction, the sickness, the change in the brain.  And after addiction, through recovery they may find little joy in living the clean and sober life.  That is part of the price of addiction and sobriety.  Addictive drugs can rewire the brain’s pleasure sensors.

Science has taught us no one is really to blame for becoming addicted.  About the only thing we can do besides stop being judgmental is to be empathetic.  “Look, that could be me,” and with the right level of pain and new pain killers, anyone can get addicted.  That’s what the fear is about our latest drug crisis: It crosses every race, age, religion, and socio-economic level.  But the same was said about black tar heroin, then cheese, maybe even meth to some extent.

Comfortably numb

Pharmaceutical companies are being blamed for convincing doctors that pain management is true medical care nowadays.  Hah, what a laugh, based on my own experiences.  One of my doctors never refilled a pain killer used when passing a kidney stone.  The specific pain killer now is highly regulated with our government telling docs to avoid prescribing it altogether.  So I suffered through a day or two of horrific pain using over-the-counter alternatives that do not work.  I knew I’d live, however.  I knew the pain would go away.

In 1990 I underwent a state-of-the-art dental procedure to remove impacted wisdom teeth.  They were sideways and were never going to sprout, so I took the option which involved anesthesia.  The moment I awoke from the surgery, the pain was excruciating.  I was given a week’s supply of Percocet, which for me really didn’t alleviate the pain.  I cried myself to sleep every night, praying for the pain to go away.  But I could not imagine not taking that pain killer.  How much worse would the pain be, I feared.  Sure enough, when the pills were gone and I called the dentist for a refill, I was told to take Tylenol.  I knew Tylenol wasn’t going to relieve that level of pain.  So I suffered for another week or so of agonizing hellish pain; it felt like my teeth had been ripped from the roots.  And that’s exactly what had happened during the oral surgery.

What was never said to me was the pain will go away.  Now we are learning that doctors want us to experience pain after surgery because that indicates our bodies are healing.  Who knew?  I figured there were the old-school docs who wanted patients to ‘suck it up’ when it came to pain after procedures and the modern docs who sympathized (not unlike Bill Clinton) and would permit patients some sort of prescription pain reliever.  I guess we’re seeing the old-school docs were right all along.  Think back to the days before anesthesia (not that I would ever want to go back, so keep it coming).  Yet those old-timers, our forefathers, lived.  Perhaps we are made of tougher stock than we realize.  Maybe we’re going to have to start discovering our inner and outer toughness.

This latest drug epidemic involving opioids brought to mind a nurse I met who cared for terminal patients.  In 1994 she was speaking to hospitals nationwide to promote better pain management for patients in the end stage of a terminal disease.  Back then doctors were very reluctant to prescribe pain killers even for the dying.  This made no sense, as the good nurse said sarcastically, “Terminal pain is no time to be giving Tylenol 3.”  She also said something else a non-medical person like me—and most of us in the general population—would know: People don’t understand opioids can be increased indefinitely.

Age brings wisdom to accept ourselves

How do we measure a year, asks the song from the musical Rent.  As I approach another birthday this month, I look back at not only this past year but all the many marks of time preceding it.  As we continue to live on, year after year, life is seen in a much bigger picture.  To me, life is marked in phases and stages.  It would be hard to explain how someone raised in a Dallas suburb ended up living in East Texas for many years and then traveled the world for education and pleasure.  But that is the wonderful thing about life: We never know what we’ll end up doing.  So, here’s to our personal adventure called Life!

Mine began humbly enough.  For three and a half years, I was the center of my parents’ undivided attention.  One of my earliest memories is our family of three moving into a new three-bedroom brick home.  I helped by carrying a mop and bucket in the house.  I remember the floor, though carpeted, felt hard as cement, which was its foundation.  My next early childhood memory was the day my brother was born.  In the hospital waiting room, while my dad was not watching, I managed to walk away until I was almost in the very room where my mother was giving birth.  I was stopped and pushed back to the waiting area by a nurse in white stockings and attire as they wore in those days.  Perhaps I heard my mother’s voice in labor and was searching to help her.

Next thing I knew, a party was held at our house with everyone coming to see the new baby.  The tiny creature was on top of my parents’ big bed.  He still had that skinny stem on his belly.  Feeling left out, I remained in the hallway then found myself carving my name on the wall.  What would Freud say?  For a few years, my name remained there until Dad paneled over it.  In those early sibling years, my brother and I shared the same bedroom.  But I saw myself as much, much older and ready for some independence: riding my big trike up and down sidewalks along the neighborhood street.  I asked to move into the guestroom, changing it into my own bedroom.  Some girls around my age moved into the house next door, and that’s where I liked to socialize and grow ever more independent.  We played Barbie’s a lot.

The next memorable milestone for me was my first day of school.  I had wanted to go to kindergarten, which was not required back then, but my parents could not afford it.  Instead because of my birth date in the fall, I had to wait an entire year before starting first grade.  I remember feeling the whole year was a complete waste of my time.  (What kinda kid was I anyway?)  My mother was a teacher at an elementary school where she arranged for me to attend.  On the first day of school, she walked me down a long corridor of lockers, then outside to the new modern wing for first and second grades, bent down and pointed at the glass doors and told me that was where I was to go to first grade.  My teacher came outside the door and the two ladies exchanged pleasantries as I walked inside by myself with enthusiasm and satisfaction and the real taste of freedom.  I had waited my whole life for this day!

But soon I would discover a few things about life and myself.  First, there are kids older than me, and they were tougher, too.  I was intimidated by them and yet could not wait to reach their big impressive ages.  Second, there were kids in my grade who were preordained to be popular.  And I was not one of them.  Looking back it seems somehow kids take one look at each other and just know upon meeting who’s well liked and who’s not.  What were we judging this on: the most stylish clothes and hairstyles, shoes, sophistication, charm school, parents with prestige and money?  How would we even know such things instinctively?  Who knows the psychology of a first-grader?  In time I would gladly accept my place as a product of middle-class blue-collar heritage.  Within a couple of years, I would learn to utilize that work ethic and make a name for myself in accomplishments that mattered to me: creative writing and performing on stage.

I won’t continue to bore with memories of junior high, high school, college and beyond, but suffice it to say, that thing about popularity is universal.  How a class of kids can be mesmerized by another person their own age is fascinating, and accurate.  You’d think the littlest ones among us would be the most sincere, able to discern the value of every peer and adult.  But kids are highly impressionable, more likely to chase after a person who seemingly glows on the inside and out.  Now with decades-old hindsight, I suppose seeing the way the world was made me more sarcastic and cynical toward my classmates, the cliques common in every school.  I never belonged to one.  Independence meant everything to me.  Besides, I liked sitting on the sidelines in observation and making the occasional sardonic quip to entertain the like-minded.

If we live long enough to mature with grace through many decades (crossing two centuries for me), then we come to realize the popular ones were just like the rest of us.  I wasn’t left out as much as I placed myself out of the white hot spotlight of school fame.  But I was critical of them, and I’ve lived to regret the way I was back then.  No doubt for some, popularity was a trap, attention and expectations never pursued.  What’s left behind for all of us are memories and pictures of beautiful kids with sparkling eyes, fabulous smiles, radiant glow and presumed successful life in all endeavors.  But the reality was and is every person has equal sorrow, hardship and loss along with love, accomplishment and success.  We of a certain age come to realize this about each other: Life may be hard but still can be and should be a joy.  If we live long enough, life gives us wisdom to understand ourselves and appreciate each other, then and now.

Too late for gun debate?

We were warned against mentioning gun control following the Las Vegas massacre—to not refer to it as a massacre or a slaughter but just another mass shooting.  We were allowed to call it the deadliest in American history.  Then as I was leaving a parking lot at the end of the week, I saw three decals on the back of a vehicle: an assault rifle, an American flag in the shape of Texas, and a cross.  The stance celebrates freedom to have a military-style rifle; live in Texas, USA; and be counted as a follower of Christ.

Imagine Jesus Christ with an assault rifle or any gun.  That would go against everything he stood for.  He is the one who suggested when someone hurts us to turn the other cheek.  That is a reference to pacifism: to not fight, to allow yet another slap on the face or physical injury, even death.  Christianity is not a religion about being locked and loaded, ready for a fight, ready to use firearms, shoot if shot at.  It’s not a religion that permits possession of and carrying a sure-fire deadly weapon for personal safety.  Christianity is about going out into the world unarmed, with sincerity and faith, and most importantly being ready to suffer and die for religious beliefs.  But if Christianity and Jesus are going to be dragged into our American gun control debate, used as some proof of ultimate religious consecration, I’d go back to reading The Bible’s red-word-only sections.

Jesus did not carry a weapon to destroy his enemies.  The Romans, however, would have loved assault rifles.  It fits their renowned blood thirst and machismo, their insatiable need to prove their ultimate strength and brutality.  Perhaps the U.S. is modern-day Rome.

The National Rifle Association—with its scant lobbying funds compared to the Chamber of Commerce and pharmaceuticals—can be blamed but a little for our nation’s escalating mass shootings, now reaching slaughter in scope and carnage.  It’s not the NRA’s fault.  These shooting massacres are the fault of every American citizen.  Who the hell thought any private citizen should own military-style assault rifles, the kind that spray bullets and kill dozens in seconds flat?

When it comes to the general public and guns, I take the word of the police chiefs and sheriffs whose associations did not support concealed gun laws.  The seasoned officers tried to warn us a couple decades ago: Every and any body should not have a gun.  But that’s what has happened, all kinds of people getting powerful guns legally and otherwise.  And Americans don’t believe in having one firearm; there are enough guns in our nation for each and every one of us, infant to elderly.  That clearly means many Americans own more than one gun.

Somehow the American love of guns and high-powered rifles has got to wane.  Our fascination with guns has gotten us into so much trouble, brought on so much heartache, been the cause of more injuries and death especially among young people than almost any other cause statistically.  The NRA may have a valid point in blaming the most recent mass shooting on the movie industry.  With a body count of 59 and hundreds injured, the scenario is reminiscent of big-budget Hollywood action movies.  But … see, movies are fantasies; they’re not supposed to be reality.

Americans have loved guns for a long time.  Our forefathers may have thought it just and good for us all (well, white men of a certain age) to have a musket around the house to prevent Red Coats or any foreign figure from taking over our burgeoning nation or from preventing our own leader from declaring himself a dictator.  Maybe thinking if every property owner had one or two firearms, it would be really hard for a foreign army to kill us all and take over our new government back in the 1770s.  Well, we’re in the at-home assault rifles and nuclear age now.

There has been comic speculation about guns and man parts, as a reason why some men have to have so many powerfully large guns (to make up for a physical lack).  If so, that is proving some American men to be the head cases that would shoot people at malls, churches, concerts, etc., etc. and then himself.

If gun control cannot be a debate in 21st century America, if Americans just cannot deal with the thought of reconsidering at least military assault rifles, then we have no choice but to look inside the mind of our fellow citizens who own tons of guns.  The federal government does do that on occasion, and look what happens: Ruby Ridge, Waco and in retaliation Oklahoma City.  All of which proves my point: Americans are generally gun crazy.  And being that way and staying that way is just plumb crazy.