-Kelly F. Merrill
The general public believes that the more than 10 million estimated intractable pain patients who require opioid therapy are getting high from taking their medications. This is a myth.
Patients access to life-sustaining, torture-relieving opioids and plant alkaloids is under attack.
Physicians must be free to practice medicine that puts your health at the center of decisions between doctor and patient…instead of perceived and exaggerated liability. Sane risk assessments based upon science and good clinical practices and empirical data are paramount.
Many pain patients are dependent upon *both* opioids and plant alkaloids to mitigate physiologically-damaging, life-shortening pathological pain of dozens of devastating pain-generating illnesses.
But when it comes to opioids, suddenly, there is some moral judgement, as if illnesses and accompanying symptoms are a moral failing or a choice. And cannabis, while effective for some patients and some illnesses is not appropriate or efficacious in treating all. Neither has it been decriminalized by the Federal Government.
Some pain patients require high doses of opioids because they metabolize opioids too quickly to get much benefit. There is a 15-fold variation in the way people metabolize opioids. This is what’s behind the myth of high tolerance. Sadly, now you know more than most pain management physicians…we’ll get to that.
As such, what might kill you won’t touch my pain, which is ever-present and nearly overwhelming every moment of every day, even with a potent combination of opioids, cannabis and Kratom.
It took a great deal of time and a great deal of pain and ungodly suffering…years of it…before doctors titrated me up to a therapeutic dose of opioids for pain control after failing a parade of adjuvant alternative therapies. Every physician I’ve ever had has been exceedingly cautious in prescribing opioids and those “therapeutic doses” weren’t quite as therapeutic as you may think.
For these purposes, we throw the “Pain Scale” out the window. My idea of a “7” is going to be a lot different than yours because I already know how much worse it can get…and it can always get worse. I only had enough pain control for those years to be just on the precipice. A truly “therapeutic dose” would have been enough medication to allow me to be a better mother to my child, a sister to my brother, a daughter to my parents, a spouse or a friend.
For the first several months taking opioid medications the only high I experienced was feeling a little chatty for about 10 minutes, once a day. Since then, I’ve never had a side-effect from the medication. People who have chronic pain and take opioids don’t get high. High doses of cannabis, however, took me over a year to titrate up on to acclimate myself to the psychotropic effects. But, as anyone who’s taken cannabis tinctures daily for an extended period of time can tell you, those effects fade away.
The best medications for me are the ones I don’t notice. I’ve ditched the ones I do notice, including a whole host of medications pushed upon pain patients that cause disturbed thinking, short-term memory loss, nightmares, racing thoughts, pins and needles, anxiety and much, much more. Unnavigable side-effects.
I do a risk-benefit analysis of everything I put into my body. I don’t eat processed foods and use simple, fresh, organic ingredients to maintain my health and the health of my son. Opioids, cannabis and kratom are no different. These are the only effective tools I have for mitigating the disabling, life-shortening symptoms of intractable illness which derailed my life and left me bed- or house-bound for over 15 years until I found my current combination of pain-relieving medications and plant alkaloids.
For over a decade, I traveled the continent in search of a diagnosis, a cure, a remedy. As such, I have a wealth and breadth of experience navigating a variety of medical systems, including the allopathic system which offer opioids to treatment-resistant patients and the naturopathic system, which prefers to use plant alkaloids. Every patient is different. Every disease is different.
Here’s an example of a chronic illness that presents differently in each patient. If you’ve ever studied Lyme disease, you know how absolutely varied the manifestations of that devastating disease are. If you’ve personally known anyone who suffers the illness, you may sense the cost to the sufferer, their families and friends. Some suffer pain, some suffer exhaustion and all have lost parts of their life to the symptoms of the disease.
And that’s just one illness. With dozens of variations in symptoms from patient to patient. Among dozens of pain-generating illnesses. Other diseases that generate intractable pain too, are incredibly challenging; especially with ill-defined or well-ignored treatment modalities and few efficacious treatment options available.
Further, there are challenges unique to treating etiologically complex and clinically heterogeneous intractable pain illnesses due to the lack of education in our medical schools with regard to treating chronic illness and pain. Less than half of physicians have ever had a single course in pain management.
It’s disheartening to see such venom catapulted toward fellow survivors, whether on social media or delivered by the evening news. The demonization of opioids is not a new story, but this time that ignorance is killing pain patients. It’s what society did with marijuana when I was growing up.
And as you know, it was all lies.