After several decades of worsening chronic back pain and a series of medical referrals, I found myself in the office of a pain management doctor several months ago. In the small, crowded waiting room I saw several people with walkers, oxygen tanks and caregivers. I swallowed hard; I didn’t like to think of myself as fitting in with that group.
As I waited to be called in, I saw that the walls, instead of displaying the usual pleasantly innocuous art, were papered with cautionary messages: always bring in pill bottles at every visit; we refuse to provide substitute prescriptions in case of lost or stolen drugs. I understood then that many of these patients were probably addicted to their medications. I silently vowed that addiction wouldn’t happen to me.
The young medical assistant called me inside and weighed me on a pull-down platform scale that I had only seen before at the vet’s office. I realized that it was to accommodate people in wheelchairs. The assistant told me he had to interview me at each visit because “people on narcotics change their stories all the time since the medications do something to their brain.” I was told that frequent urine tests were required to assure the doc that you were actually taking the medication he had prescribed, and not bootlegging it to someone else.
After a brief conversation and a review of my updated dismal test results, the doctor prescribed opioid (narcotic) patches. Opioids are supposed to block pain signals in the brain. He started me on the lowest dosage, a patch about one inch square costing $40, which I was to place on my upper chest, upper back or upper arm for a week, and then change for another. After several weeks with no positive results he doubled the dosage. Now each slightly larger patch cost about $75, but sadly, still no result. Did I have a stubborn brain? Why wasn’t I getting any relief?
The doctor now prescribed an oral opioid, starting at a low dose three times a day. I dutifully took the pills for 16 days, again with no positive result but with some unpleasant side effects including rapid heartbeat, sweating, and the “opiod induced constipation” (OIC) that you have probably seen in TV commercials. I chastised myself for ever getting on the opioids, because my experience throughout the years was that each medication I tried caused another problem. But I had so desperately wanted a solution to pain that I had resolved to give this a chance.
I decided that I wanted to get off of these pills. I was offered other drugs but vehemently refused. The doctor told me because I was taking a narcotic, I couldn’t just stop, but had to taper off. He told me to take two pills for four or five days, and then drop to one pill for four or five days, and then stop. I was informed that because I had been on the medication for a short time, I shouldn’t have a problem.
After I dropped to two pills I began to experience the opposite of OIC and in fact lost 5 pounds quickly. After four days, I dropped down to one pill. That night I experienced drug withdrawal symptoms that reminded me of what I had seen in the movies. Ankle and foot spasms, restless leg syndrome and rapid heartbeat kept me awake until 5 a.m. Exhausted, I was able to get about 45 minutes of sleep in the early morning.
The next day I called the doctor to ask for advice. I was told to get back on the medication to prevent the withdrawal symptoms. I protested that in this way I would never get off of it. I decided to stop the drug completely and hoped that the first night on one pill was the worst I would experience. For the next two nights, I had similar but less drastic symptoms. After three almost sleepless nights I was feeling debilitated. For several days I rested on the couch or in bed, then finally felt fairly well recovered from the opioid nightmare.
With the doctor’s prescription, now I am enrolled in aquatic therapy with the hope that strengthening exercises will be helpful. I walk on an underwater treadmill and perform leg, arm and core exercises. It requires a big commitment of time compared with simply taking pills, but it is not invasive.
Francine M. Farber is a retired school district administrator and a full-time community volunteer.