Recently I spoke with a pain management physician in southern California. He has been in practice a number of years caring for patients suffering from chronic pain.
But that is changing.
“Dr. P.” contacted me after experiencing the fallout from a series of articles in the Los Angeles Times on pain care in southern California. The Times reporters focused on a handful of doctors who cared for very difficult to treat people, some of them addicts, who came to them seeking prescriptions for pain relievers.
These patients had unsuccessfully sought help from other caregivers prior to seeking out the physicians written about in the Times. These doctors took on pain patients with intractable conditions. The Times reporters wrote that these physicians had, in their view, been responsible for too many deaths in their practices. They concluded that those deaths were the result of poor practice and lax patient management.
Dr. P. worries that these often erroneous reports, in combination with regulatory and law enforcement agencies, have created a hostile atmosphere for both pain care providers and their patients. He believes that this atmosphere has become corrosive to treatment for those seeking relief from chronic, often debilitating pain.
Dr. P. says pain care providers in southern California are now often targeted by medical boards, regulatory agencies like the DEA, and other law enforcement agencies when they are deemed to have prescribed too many opioids to patients who later die. He adds that many physicians now refuse to take on these very ill and difficult to manage patients because it could jeopardize their practice or result in criminal prosecution.
Dr. P. introduced me to one of these patients, Lilia Mora, who he was fearful of taking on because of possible regulatory interference and unwanted contact with law enforcement agencies. He couldn’t take the risk of treating her because of these barriers, but he wanted very much for me to tell her story. Dr. P. believes it is emblematic of many patients with pain in California and elsewhere in U.S.
Ms. Mora is a 36-year old single mom with six children ranging from 4 to 20 who, with her children, now live with her parents in southern California.
A few years ago, Mora was diagnosed with a brain tumor. She had been suffering headaches and the loss of motor skills and coordination. Though I didn’t notice it when interviewing her, she said that she also has trouble speaking clearly.
In 2010, Mora underwent surgery to remove the invasive tumor. She told me that 93% of it was surgically removed and the remaining 7% was destroyed by radiation.
Mora has been in remission since then, but she has been in terrible life altering back pain. She has also suffered the loss of use her left hand due to uncontrollable shaking. Needless to say, she is no longer able to work.
“The pain has been so bad I had to quit work and haven’t had a job in a long time. I’ve needed help showering, cleaning, everything,” she told me.
Mora explained that her husband left her because, she believes, he couldn’t live with someone so disabled. Research shows that more than 80 % of the marriages where one of the partners is chronically ill or in chronic pain end in separation or divorce.
Not only did she suffer the rejection of her husband, but now, when in public she believes that “people look at me as being different. I’m no longer like them, just different.”
Mora underwent spinal surgery that left her with much reduced movement of her head, thus increasing her disability. She also suffers from the initial stages of arthritis.
Like so many others in chronic pain, Mora has fallen down the socioeconomic ladder. Her medical care is covered by Medicare, but that limits her treatment options as many providers choose not to deal with Medicare. She receives $1,246 monthly in Social Security disability and pays $100 to $200 monthly on medical bills not otherwise covered.
Mora worked for a time with a pain specialist who offered trigger point injections and ultimately methadone. Using methadone scared her, so she declined his offer. She was referred then to a neurologist, who suggested she try another pain management practice.
In addition to 4 to 6 hydrocodone pills a day, Mora takes 12 other medicines. But she still finds caring for her children and helping around her mother’s house too painful, thus increasing her very real sense of emotional isolation.
When I originally spoke to Mora in April, she had contacted five pain practices, all of whom refused to take her on. As of this writing, she is still struggling to find a physician who will treat her pain.
Like so many other patients in California and other states where the war on pain patients is in full bloom, Mora suffers from the widening holes in pain care. This is brought about by the zealous opposition to opioid medicines that leave so many untreated, in horrible pain, suffering from depression, and often looking to the streets for illegal relief.
We can, unfortunately, count on statistics to support the horrible reality that many people with pain will opt for suicide in lieu of unavailable treatment.
Across the country there has been a spike in people turning to heroin, and I imagine research will show that a large portion of the new demand for heroin comes from desperate people living with pain left with no legal options.
These conditions are immoral and scandalous, and should not stand.
Mark Maginn lives in Chicago where he is a poet, writer and social justice activist. Mark suffers from chronic pain and was a longtime volunteer with the American Pain Foundation. His blog “Left Eye Blind” can be found here.
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represent the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.