I’m reading a book about a drug dealer who only deals in legal painkillers and only sells to people in pain who can’t get the drugs from doctors and pharmacists. I do know people who have had to resort to buying their legal drugs on the street because doctors won’t prescribe the amounts they need, and even if the doctor did prescribe the drugs, pharmacists wouldn’t supply them. There are a whole lot of people falling into the cracks created by those who are trying to curb the so-called opioid epidemic.
According to the Mayo Clinic, about 10% of those who are prescribed opioids get addicted, and another 30% misuse the drugs. Although they give no explanation for the misuse, I do know that often the dose the doctors prescribe is too low to manage the pain, and either the doctors can’t or won’t up the dosage for fear of addiction, so people either suffer or take more than is prescribed. Even after doctors have established that a person is dying, they still withhold needed painkillers lest their patient become addicted. As if a person dying of cancer really cares if they become addicted — they want whatever life they have left to be as comfortable as possible. (That’s one thing that hospice does right — makes sure that people get the drugs they need for comfort. Unfortunately for me, if I ever end up in that situation, their drug of choice is morphine, which does absolutely nothing for me.)
For those who get addicted, it is a terrible thing, but so is withholding pain medications from those who desperately need them because of that 10%. Still, the vast majority of people who take opioids don’t get addicted.
The only time I took heavy painkillers was after I destroyed my wrist and arm. The doctor was more than willing to prescribe the pills and even prescribed a high enough dosage to manage the pain. The problem was the pharmacists. What ogres they were! The first pills I was prescribed didn’t work, so the doctor gave me a prescription for Percocet. The pharmacy closest to me didn’t carry Percocet, and the next pharmacy was going to throw away the prescription because they figured I was scamming them. Yep, me, with a device like a mini sewing-machine attached to my arm, bloody bandages still visible (because doctors are rethinking the idea of constantly changing bandages; apparently blood is clean but air isn’t). Those people stared at me with cold eyes and watched until I left the store. I finally found a pharmacy that had the drugs and would fill the prescription, but they fought me on it because the records showed I still had some of the first pills left. A couple of weeks later, when I went to get more pills, they refused to sell them to me because their records showed I should still have half of them left — even though the prescription was for six a day, the pharmacist thought I should only be taking three a day. Many tears and a long confrontation later, I left with painkillers. Truly a horror!
I’m lucky in that my pain was relatively short-lived — six months vs. the lifetime of pain some people suffer. I also hated the pharmacists way more than I hated the pain, so I weaned myself off the pills long before the six months were up even though I still had pain because cripes, who wants to be treated like a criminal when all they want is to get their legally prescribed painkillers?
I don’t know what the answer is. I do know people shouldn’t have to suffer when the means to minimize the pain is available especially since 90% of them won’t get addicted. I do know that people shouldn’t have to be reduced to illegal activities to get the medication they need. And yet there is that 10% who do get addicted. There must be some way to catch the addiction early so that no one becomes addicted and no one has to deal with pain, but apparently that is beyond today’s pharmaceutical industry.
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Pat Bertram is the author of Grief: The Inside Story – A Guide to Surviving the Loss of a Loved One. “Grief: The Inside Story is perfect and that is not hyperbole! It is exactly what folk who are grieving need to read.” –Leesa Healy, RN, GDAS GDAT, Emotional/Mental Health Therapist & Educator.
Bertram's Blog 
February 10, 2023 at 12:56 am
The best explanation of addiction I’ve run across is a short-term, self-soothing behavior which causes harm in the longer term. Recognized addictions (including; opioids, alcohol, work, sex, gambling, food, etc.) seem to fit this explanation. Some behaviors not recognized as addictions (hoarding, risk seeking, even grief) might also fit.
Dependency, by itself, seems insufficient. For example, we’re all dependent on food. Many of us find comfort and self-soothing in food, but it may or may not result in longer term harm.
I don’t know the answer either, but it seems evident that prohibition isn’t likely it. Restriction seems an unlikely answer too (are we going to have government agents monitoring my cookie intake?). Predicting and/or preventing addiction in any given individual isn’t likely to be any more effective than predicting any other individual activity in advance.
A more likely answer would seem to be expecting and requiring adults to assess the risks and benefits of their behaviors for themselves, and to provide assistance and harm reduction in cases where that fails. I’m afraid it’s a pretty hard sell though. There are just too many vested interests in the prohibition/restriction model.
February 11, 2023 at 7:59 am
That’s a good definition of addiction. Sugar fits in with that — a short term self-soothing behavior that eventually causes a lot of harm.
I would have thought it would make sense for each adult to assess their own situation when it comes to how opioids affect them, but yeah, there are all those vested interests. It’s weird in a way that there is so money to be made by prohibition and restriction.