By Angelika Byczkowski
CDC Guideline Assumptions
As a pain patient with over 20 years of successful opioid treatment experience, I’m offended by the CDC opioid prescribing guidelines, with their assumption that I’m stupid and lazy (if my pain is even real in the first place) and that my doctor is ignorant and negligent.
I’m insulted by the derogatory appraisal of patient behavior and appalled that the CDC has broadcast such a devastatingly negative stereotype of pain patients. Coming from the government’s “Center for Disease Control”, these guidelines stigmatize patients more powerfully than articles in general publications.
In the guidelines, the folks of the CDC and their enablers from PROP portray paint pain patients as 1. lying, 2. lazy, 3. ignorant, and 4. whining scammers, assuming the very worst of human motives and behavior.
This brings to mind the psychological truth that we are generally most disturbed by others’ behavior when it reflects our own shortcomings, which leads to the inference that the rule-makers themselves are actually the lying, lazy, ignorant scammers they accuse pain patients of being:
- Their lying is exhibited in the deliberately flawed and prejudicially skewed statistics they used.
- Their laziness is evident in their refusal to work on the real problem, which is addiction.
- Their ignorance shows in their many flawed assumptions.
- The scam is that they are trying to make people desperate enough to submit to extremely profitable interventional surgeries or push them into extremely profitable addiction recovery programs.
The people who are fabricating all these new rules about opioids base them on inaccurate presumptions and stereotypes, eagerly provided by PROP and other anti-opioid zealots.
They assume I don’t exercise (and probably never have), that I’m totally out of shape, fat and lazy, that I’m completely unaware of nutrition and eat nothing but way too much junk food.
They assume I went whining to my doctor with some annoying aches and pains (which I mainly brought upon myself), upon which my doctor just whipped out a prescription pad and prescribed huge amounts of opioids, for which I keep getting refills even though I haven’t been examined in years.
They assume opioids are the first and only pain management methods my doctor and I
chose, that I didn’t already spend thousands of dollars trying multiple courses of ineffective “alternative” or “complementary” treatments (which also have no evidence for long-term effectiveness), and that I didn’t try multiple rounds of physical therapy.
They assume I never tried non-opioid medications, almost lost my sanity taking the recommended antidepressant (Cymbalta), almost fell down with dizziness from the recommended antiepileptic (Lyrica), and consumed huge bottles of ibuprofen and acetaminophen tablets – all before trying opioids.
And they insult me even further by claiming I’m so unaware that I’m “thinking myself into pain”.
The guideline writers assume I haven’t already for years applied mental techniques to reduce my pain perceptions, that I haven’t been scouring the psychological literature seeking mental pain remedies and that I haven’t tried all kinds of “visualizations” and meditation methods.
They assume I’m magnifying my negative thoughts, dwelling on my pain, and that I need Cognitive Behavior Therapy to straighten out all my “not really true” negative or fearful thoughts. They accuse me of catastrophizing.
But what if anticipating catastrophic pain and fatigue is not just a negative belief, but an appropriate life concern?
They casually dismiss concerns about the debilitating effects, internal and external, of constant pain and assume they know more about my pain than I do. In their thoughtless arrogance, they believe they know the certain path to pain relief without opioids, though this has eluded millions of people for thousands of years.
They assume I’m just a dumb, passive, and annoying pain patient, someone who doesn’t know anything about her body and doesn’t want to know, someone just complaining and waiting to be fixed by a magic pill.
They assume I haven’t suffered enough, haven’t lost enough, haven’t been desperate enough to do anything and everything in my power that had even a remote chance of easing my pain.
Opioids are the last pain treatment I tried, and the only pain treatment that works for me.
Here’s a photo showing a situation that would certainly be painful. I picked this instead of another picture showing handfulls of pills that only reinforce the addiction stereotype.
Until she was disabled by progressive pain and fatigue from Ehlers-Danlos Syndrome and Fibromyalgia, Angelika was a high tech IT maven at Apple and Yahoo, and a competitive endurance athlete. She lives in a rustic cabin in the redwood forests of the Santa Cruz Mountains just up the hill from Silicon Valley with her husband and various 4-legged kids.
When her pain allows, she spends her limited energy researching, writing, and blogging about Chronic Pain, EDS, and Fibromyalgia at http://EDSinfo.wordpress.com and writes poetry to sustain her sanity.