I have often made light of my own physical pain by saying: “Pain is your body’s way of saying you’re alive! Some of us are just more alive than others.” Or I’ve been heard to say, “It’s only pain” (which is the little boy in me who wants to scream and cry trying to be a big boy because my dad always said “men don’t cry!”).
Recently, I’ve been spending a lot of time and energy trying to help a dear friend through withdrawal from two powerfully addictive prescription pain medications, morphine and percoset, which are both narcotics.
She was prescribed these for pain management in preparation for necessary back surgery about nine months ago. As one psychiatrist recently stated, she should never have been allowed to continue on those prescriptions that long. She hasn’t had the surgery yet, but those meds were only intended to be for short-term use, due to the severity of their addictive and psychological effects.
So, when my friend was cut off, she was faced with “cold turkey”. This actually brings me to my topic.
First, I want to talk about pain and pain management. I believe that pain is an inevitable part of life. That is not a cynical, dark, gloomy, or defeatist perspective at all. Quite the contrary. How is strength developed and proved without testing? If you never have to endure anything, how do you know that you can? Pain is inevitable. Pain is opportunity. Am I crazy enough to suggest that we should welcome and embrace pain? Probably not.
This brings me to pain management. There are physical conditions that cause constant physical pain; i.e. fibromyalgia, or my friend’s vertebrae condition. Constant physical pain causes the body to want to minimize the pain by minimizing movement. Sometimes this seems to give temporary relief. However, this has both physical and psychological ramifications. Physically, because the human body is designed to move, when it doesn’t, muscles begin to atrophy, joints begin to stiffen, often there is weight gain in the form of fat cells. All of these complications make movement more painful, and feed the vicious physical cycle.
Now, to the psychological aspect. First, let me say that I am not a psychologist or psychiatrist or any other kind of medical or scientific expert. Secondly, I am speaking in generalizations, and so, of course, these are not universally true. These statements are based on my experiences, observations, and prayer. [I have to write these things in case what I say offends someone].
Simplified, as we feel less physically able to do things, depression can get a foothold in our minds. We can start feeling unable to do anything, and lacking any worth. Sleep disorders develop. Psychoses rear their ugly heads. As relationships in our lives are inevitably strained and dissolved at this point, depression can bring it’s close friend, paranoia. Now, we have a person who is in severe and constant physical pain, which is intensified by the psychological pain of depression. Moreover, this person has little or no support structure of friends.
There are physicians and pain management centers out there who want to help this person. The first step is to try chemically to bring them back to a point of functionality. This is usually done with anti-depressants and narcotics. The intention is to work with the patient toward not needing the medications.
However, here’s what happens sometimes. Put yourself for a moment in the place of the patient. Maybe you’ve already been there. Maybe you’re there now. The doctor gave you some prescriptions that may have even used the language “…as needed” on the label. When you took them, for the first time in a long time (maybe even ever) you felt good. You weren’t high or anything like that; but pain free, and that is euphoric! Maybe for a while, you followed the prescription dosage exactly, and received relief.
But then one day, you had a lot of stress (stress, like pain, is inevitable). Maybe you even had a minor injury, twisted your ankle or something. You took an extra pill. No harm came to you. You didn’t overdose. In fact, you felt great. No pain, and the relief lasted longer. So, you decide that’s going to be your regular dosage. Possibly without your consent, your body had begun to develop a tolerance level for your pain medication already; whereas it would begin to require a higher dosage to receive the same benefit.
Now, here’s a theory I have about narcotic’s effect on pain management: Narcotics hinder and possibly destroy our body and mind’s ability to manage pain. A completely pain free life may sound desirable, but I think it’s like the unused muscle. It becomes unusable, and eventually dies. When the person has become accustomed to the pain free narcotic life, and the narcotics are suddenly removed, the first reaction is panic, based on a remembrance of pain. I heard the phrase “I can’t handle it!” a lot lately. My friend had become convinced that she couldn’t handle it. This is a woman who had given birth to two children; the second was a 30-hour labor and was actually the cause of her back injury. But she was terrified at the impending pain. She was literally experiencing it before it got to her, through panic. Panic is not just an emotional reaction. It causes muscles to tense, which, of course, can make pain worse.
The second reaction when the narcotics are removed is when the pain actually does arrive. By this time, the person is in such a panicked state, the distinctions between this stage and the prior are subtle. In the case of morphine withdrawal, seizures, cold sweats, violent shakes, hallucinations, delusions, vomiting, difficulty breathing, suicidal tendencies, violent outbursts, fever, and some other very challenging symptoms occur. According to one source, withdrawal from morphine may take up to six months, if the patient survives withdrawal from cold turkey. This is what my friend was going through. She was in a car accident, and became violent at the hospital ER because they gave her what would be a normal pain medication treatment, which of course had no effect on her at all. She has been turned away from many medical professionals in the area because of caring family members who are making sure that she cannot get narcotics from them. This has caused my friend to have many violent outbursts toward her family, but I say they are doing the right thing. It’s hard. Nevertheless, my friend needs to come to a point where she can no longer get access to the narcotics, legally or illegally.
But, back to pain management. I want to draw a few similarities. A doctor told me once that frequent use of eye drops (i.e. Visine) for moisture will shut down the eye’s natural ability to produce lubrication. Those eye drops are fine for occasional use under extenuating circumstances, but if you use it all the time, then you will HAVE to use it all the time. Another example would be the over-the-counter sleep-aids. While they are not physically addictive substances, if you take them every time you want to go to sleep, they will become the only way you will be able to go to sleep. Your body will stop producing Serotonin and you will be dependent on the sleeping pills.
Our body produces endorphins to help deal with pain. I want to speak more about how we psychologically manage pain. Each person has a natural tolerance level for pain. This is the amount of pain or discomfort a person can endure before they are truly stopped. It is different for everybody. Some people just naturally seem to be the lumberjack who accidentally cuts off his arm with a chainsaw, but keeps working. Others have to stop whatever they are doing and immediately tend to a hangnail (they do hurt!). Now, just because we are given a particular level naturally doesn’t mean that’s what we’re stuck with. That lumberjack, for instance, might need to develop sensitivity to other people’s pain, or the hangnail person might feel dysfunctional because of it. There is hope for the whole spectrum! We are able to expand beyond our natural boundaries if we first see them as a starting point, not a rut from which to attempt escape!
Most people would seek to increase their level of pain tolerance, or at least that’s what they’d say until they heard what they’d have to do in order for that to happen. Distance runners speak of a point, I believe the term is “the wall”, where they have ENDURED THROUGH the pain, cramps, exhaustion, and all the things that go on inside the heads of those crazy runners,and suddenly, there is no pain, motion is effortless, there is no exhaustion, and they feel like they could run forever.Insanity? Perhaps. I think the most important part is that this POWER comes to the runner AFTER THEY HAVE ENDURED. We don’t like to endure. It’s hard. It hurts.
My friend will have to endure a lot of pain, physically, emotionally, spiritually (in the drug-influenced madness, she did a lot of things she would not normally have done), and psychologically before she can truly be free. The end result, I pray, will be a mother restored to her precious children… a daughter, sister, granddaughter restored to her family… a Christian soul who has struggled, restored to her Heavenly Father… and a gifted, intelligent, and loving young woman restored to herself.