THE OPIOID CRISIS, ME…AND YOU

By Eleanor Jaffe

     I don’t know about you, but the current opioid epidemic in the U.S. feels… distant.  I don’t personally know anyone or anyone’s child who is “hooked.”  But when I think more deeply, I must admit that prescription drugs almost did me in about twelve years ago.  At that point, it was less well known that prescription drugs, painkillers, are often the gateway to addiction.  At least it wasn’t known to me.

      It wasn’t really known to physicians, either.  Siddhartha Mukherjee wrote in the NY Times Magazine on February 4 that “We were living, then, in what might be called the opioid pre-epidemic…Pain, we had been told as medical residents, was being poorly treated (true) —- and pharmaceutical companies were trying to convince us daily that a combination of long and short-acting opioids could cure virtually any form of it with minimal side effects (not true.). The cavalier overprescription of addictive drugs was bewildering….”

     So I write this as a cautionary tale.  Major surgery may be in your future as it was in my past, and terrible pain may accompany it.  The use—or overuse—of painkillers, Vicodin, Percocet, or Oxycodone, can lead to dependency or getting “hooked.”  That’s what happened to me, at least temporarily….and innocently.

   My major surgery about twelve years ago was double knee replacement.  My painful arthritic knee joints which had limited me in so many ways were replaced by artificial ones.  Both were done at the same time during the same surgery, and while it was a success, I was in terrible pain for several months. 

    I needed “heavy duty” drugs to keep me going, to tolerate movement and physical therapy, even to sleep.  The labels read, “Take 2 every 4 hours,” and “Take 2 every 12 hours,” and “as needed.”  At the same time, the advice was to “Stay ahead of the pain,” that is, anticipate that you will be in pain, so take the medication before the pain seizes you.

     But if you “Stay ahead of the pain,” how will you even know if you need the pain killer? And how will you know when it is time to ease off the medications? This was the conundrum, at least for me.

     My surgeon was no help.  When I told him, after one month, that I had become melancholy and depressed, was frequently crying, and had no appetite (I lost 14 pounds in 6 weeks), and (almost distressing of all) I could not understand what I tried to read!  He simply told me to “get off the drugs.” But when I tried to stop the meds completely, it was worse.  I was in terrible pain.

     Another physician—my son who practices physical medicine and rehabilitation 2,000 miles away in Utah—advised that I needed the meds, but that I needed to get on a regimen of phased withdrawal, gradually reducing and then extinguishing my needs.  “I can’t believe this is happening to my own mother!” he said.  It took three months to get past the need for the drugs.

     Physicians are now well aware that prescription medications—their prescriptions—provide gateways to addiction.  Physicians are supposed to limit the amount of these prescription meds to a few at a time.  Additional meds now require additional prescriptions.  And yet, too many are willing to keep signing prescriptions.

     This is a “painful” story in many ways:  my gullibility regarding pain medication, my “addiction,” my poor choices, my surgeon’s insensitivity and mismanagement of my condition post-op, and more.  But in light of the opioid crisis facing all of us in this country, I share this dismal and frightening medical history with you.  After all, you, too, may be a candidate for major surgery with its accompanying pain.  Be wary of these painkillers.  In the short term, they relieve your pain.  In the long term, they cause addiction and possibly even death. 

As I grow older, I am more interested in the conditions, changes, services, culture, and even politics affecting me, my husband of over 50 years, my friends — and my 100 years old mother.  What does it mean to be growing older in today’s society?