[Rant] On public perception of painkiller use

[inulro]

I just finished watching last night's episode of House, in which yet again the assumption that everyone who takes pain medicaiton is an addict who should live without it. To be fair to the show, at the end House admits that he is an addict (boo hiss) but insists he won't stop taking his Vicodin because otherwise he's in too much pain to be able to work. At one point Dr Cuddy says "there's other methods of pain management" which, being a doctor, she should know DON'T BLOODY WORK. The other doctor whose name I forget blames all the ways in which House has changed since his accident on his Vicodin popping. It couldn't possibly be because he's had trouble adjusting to being disabled and the constant pain.

I think there's also a school of "thought" that doesn't believe in chronic pain because modern medicine should be able to fix the root of the problem and thus it's all made up.

People who live with chronic pain really do not need the pain relief=bad message spreading. There's been more than one New Scientist article recently (none of which I can find online so you'll have to take my word for it) outlining how doctors on both sides of the Atlantic are losing their licences because they are deemed to be prescribing too many opiate-based painkillers. In some cases doctors are not prescribing them to terminally ill people in agony (in whose case, even if the hype were true, surely painlessness would be better). But no, we can't have stoned end-stage cancer patients out there.

Put it this way - people with heart conditions aren't called addicts and encouraged to get off their meds. So why should chronic pain be any different? Yes, opiate based painkillers have bad side effects. I try to keep my own usage down because it's not doing my liver & kidneys any favours. But all medications have side effects - it's basic science.

Shortly after my car accident, I had friends expressing worries about my painkiller intake (not opiates, your friendly neighbourhood neurofen because I still thought I was allergic to codeine at the time). My reply was that frankly I was more concerned about the fact that my back pain was not going away and nobody would listen to me.

I don't claim to live with chronic pain, just chronic discomfort that occasionally makes forays into pain territory. But I do know that if I find it this distracting and difficult to live with, actual chronic pain must be truly, deeply awful. Being told that you should just live with it because some irresponsible people get high with the drugs that make you feel like a human being is beyond insulting.

Comments

[sushidog.livejournal.com]

To be fair, House did point out that, while he's addicted to the painkillers, they're not a _problem_, and therefore he has no intention of quitting; they allow him to do his job and live a normal life. But yes, I do see your point; chronic pain is very poorly understood even by the medical profession, as far as I can tell, let alone the general Channel 5-watching public!

[inulro.livejournal.com]

My point exactly: if it was heart medication, and he was taking it (with side effects) and it was working, it wouldn't be called addiction. While I admire the program makers for having him continue with the drugs, I don't like the use of the word addict.

[ivory-goddess.livejournal.com]

Hester (as so often the case) said what I was going to. House described himself as functioning, which he wouldn't be without the pain meds.

[the-siobhan.livejournal.com]

One of my major rants. I really think our health-care system under-medicates for pain.

I have observed a fair bit of sexism in there as well, in who gets believed when they complain about chronic unmanageable pain.

[aeia.livejournal.com]

I think they're pretty good with acute pain, but less so with chronic pain.

[aeia.livejournal.com]

I'm the opposite, I tend to ignore the pain when I should take painkillers. My body loathes opiates though so I'm left with few options. At the moment I'm just taking paracetamol for my foot when it gets uncomfey. Ibuprofen is now out as it supresses bone healing!

[inulro.livejournal.com]

I can't take Ibuprofen any more - after 6 months at 1800 mg/day after the car accident, it just doesn't work any more.

I rarely take my codeine during the day, but I take it at night because otherwise I can't get comfortable enough to sleep. AS I have difficulty sleeping anyway, I'd never sleep otherwise, and that's not a sight anyone wants to see. Having said that, I take about 2 mg of codeine, which is hardly anything, but paracetamol had stopped working years ago so I had little choice.

[girfan.livejournal.com]

*aggreement*

I've had a few periods of my life (in the past 7 years) where I was told by doctors to take Nurofen Plus/Co-codimal/strong Ibuprofen in order to help heal me. It worked. I don't need to take any of it 90% of the time now, but when needed, it's helped make my life better.

Especially after my recent bout with foot/knee problems, I understand what friends with chronic pain go through and sympathise.

[50-ft-queenie.livejournal.com]

Hear hear! The refusal to prescribe opiates to terminally ill patients still infuriates me.

[ivory-goddess.livejournal.com]

I read that New Scientist thing - I think it was an editorial. Basically, it was saying that opiates are frowned-upon, politically speaking, because of their association with illegal drugs, so Drs are inclined to prescribe newer, non-opiate painkillers that then get withdrawn over safety concerns! (double the risk of heart attack or stroke with one particular one). The editorial pointed out how stupid it was to avoid using tried-&-tested painkillers with few, but known, side-effects simply because of an association with illegal drugs. And I'm afraid that when it gets to terminal illness, if the patient wants to be off their head with pain relief, does it really matter?