Living with Pain: Physician Abandonment and Suicide in Florida

Living with Pain: Physician Abandonment and Suicide in Florida

Last December, Joe Malone came home from work and found his wife, Michelle, dead from an intentional overdose of prescription medicine. She was only 49.

“I lost the person I loved most in the whole world. She’s never coming back. I’ll never be the same person,” Joe says of his wife’s suicide.

Like thousands of other pain patients, Michelle was a casualty of a war on drugs gone mad. The battlefield was Florida – a state that’s enacted tough laws and regulations to combat the abuse of opioid medicine. The crackdown has led to the needed closure of many pill mills, but it has so intimidated doctors and pharmacists – who fear losing their licenses — that many are denying opioid analgesics to legitimate pain patients.

Some patients, like Michelle, simply can’t live with the pain anymore.

Michelle and Joe Malone

It was twelve years ago, when the Malones were living in Middletown, Connecticut that Michelle was first diagnosed with Reflex Sympathetic Dystrophy (RSD), also known as Complex Regional Pain Syndrome. RSD affects the skin, bones and joints with searing pain.

Michelle learned that RSD was little understood and often treated with skepticism by doctors – many of whom are not adequately trained in pain medicine.

Like so many other pain patients, Michelle heard the most destructive thing a physician can say, “The pain isn’t real, it’s all in your head.”

RSD spread insidiously throughout her body, leaving Michelle in excruciating pain that led to despair, fleeting hope and recurring disappointment. She tried using opioid analgesics, such as a Fentanyl patch, but they only lessened her pain and did not stop it.

Michelle’s doctor recommended that the Malones move to a warmer climate. They followed that advice six years ago and relocated to Pensacola, Florida with all of her medical records and a referral to a pain specialist there.

Abandoned by Physicians

Michelle was referred to a well-respected pain clinic in north Florida, where a physician came up with his own medicine for pain, a formula mixed by a nearby pharmacist. This provider required all his pain patients, including Michelle, to discontinue all the drugs they were taking before they would be given this new medicine. Predictably, Michelle entered withdrawal as she came off the opioids too quickly.

As part of her treatment, Michelle was required to travel to the clinic weekly for an educational support group. It was a 45-minute drive from her home to the clinic. Michelle couldn’t drive herself and needed Joe to take her to appointments, but Joe couldn’t always get off work to do that. After a few missed meetings, Michelle was first warned and then dropped from the practice for failure to comply with the treatment plan. For Michelle, this was another in a line of physicians who abandoned her. Thoughts of suicide and a desire to stop the relentless pain increased.

“It really messed with her head, nobody wanted to help her. This is why she was depressed,” Joe recalls bitterly. “We had to rely on emergency rooms, but they treated her like shit, saying she was drug seeking, Not true. She only wanted relief.”

Like so many others inadequately treated for pain, Michelle’s condition deteriorated. She couldn’t work, do house chores or care for herself. Though often confined to bed, she developed insomnia.

“I would hold her up and we’d pace around the house for hours, it was the only way she could cope with the sleeplessness and pain,” said Joe.

Four years before her suicide, Michelle finally found a physician who understood RSD. Michelle saw her regularly and faithfully followed her medical orders and advice. Again, she relied on an opioid analgesic to lessen the pain. However much relief she gained from this treatment, it left her in lonesome anguish.

Michelle saw her physician for her regular appointment on December 16, 2011. According to Joe, she came home from the appointment to find a letter that explained to her in vague terms that her physician would no longer prescribe her medicine and would no longer treat her.

“You know what I’ll do if I can’t get my medicine,” she said that night in despair when Joe returned home from work.

Yes, Joe knew. Michelle had attempted suicide before, after other practices abandoned her.

Two days later, on December 18, Michelle took her own life.

Climate of Fear

There is a climate of fear and despair in Florida among pain patients who can’t get good medical care or have their opioid medicines filled in a timely fashion.

Yes, the public needs to be protected from opioid medicine abuse. But legitimate pain patients whose only relief comes from a combination of treatments that often entail opioid analgesics also need protection from the hysteria among the media, certain health care providers and politicians.

There are all too many reports of pain patients dying from complications of pain or from suicide. It’s not just despair that causes many pain patients to opt for dying. It is the only way many can think of to stop their agony.

What is so disturbing about what happened to Michelle and uncounted others in Florida and throughout our country is the cavalier abandonment of our most endangered patients. Michelle’s death was an entirely predictable tragedy resulting from our misguided war on drugs.

There are many resources available for people having suicidal thoughts, including a toll free hotline where counselors are available 24 hours a day. Family members or loved ones can also find tips about suicide prevention and spotting the warning signs of suicidal behavior. 

Mark Maginn

Mark Maginn lives in the east bay of San Francisco 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 can be found here

The views, opinions and positions expressed in this column are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of American News Report, Microcast Media Group or any of its employees, directors, owners, contractors or affiliate organizations. American News Report makes no representations as to the accuracy, completeness, currentness, suitability, or validity of any information in this column, and is not responsible or liable for any errors, omissions, or delays (intentional or not) in this information; or any losses, injuries, and or damages arising from its display, publication, dissemination, interpretation or use.

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There are 15 comments for this article
  1. Ouchithurts at 4:04 pm

    Sir-
    Unfortunately I can empathize with this article. It was 4 years ago that I herniated a disk in my neck while lifting a patient in a residential care facility while working for New York State. I was 36 and I did not want to undergo invasive back surgery.
    For the Last 10 years I have seen the same PCP. At my last office visit I was told I was being discharged as a patient because my doctor could “no longer treat my pain”. O.K., but isn’t that what doctors do? I will spare you the details of my personal suffering and instead I will cut to the chase and tell you the real reason why.
    I found out from his nurse that my doctor had a professional relationship with another doctor. This other doctor was jailed for writing false prescriptions or some such shady business. This resulted in my physician “taking in” the jailed doctors patients. This apparently interested the DEA as he was “red flagged” by them for prescribing too much opioid medication.
    I went in for a scheduled appointment to discuss altering my medications as I felt that a 50mcg Duragesic patch was overkill for my symptoms. This resulted in my immediate discharge. I left the office stunned, confused, and feeling abandoned.
    Only later did I find out the details and the real reason behind his actions. It would be easy to blame the doctor but I tend to take a wider view and I do pay attention to the man behind the curtain. The “War on Drugs” has found a new target. Doctors and persons with conditions that cause chronic pain. Lets call a spade a spade. This is simple discrimination against persons with disabilities. It pained me (no pun intended) to read that story. I know how she felt all too well.

  2. Theresa Hamilton at 10:20 am

    My thoughts & prayers go out 2 the family that lost their loved one. I suffere with CRPS TYPE 2. I agree it’s terrible that so many R abusin meds 2 get a high while so many that R sufferin can’t get the meds they need even tho they have medical proof/visible proof of their sufferings they’re still turned away, not taken seriously, treated as though they’re drug seekers, just complainers/whiners..over reacting, & even what is being given with most aren’t even touching the pain. when they explain 2 the Dr. they act as though there’s nothing else they can do, knowing there’s stronger meds, pain pumps(which would be controlled & no way 2 sell or abuse that) but little or nothing’s done…the person/persons suffer daily & many times the pain gets too bad & they just end their life after seeking help for so long with no relief. There’s a problem with this issue & there needs to be a change in our system. Most times it’s a lack of understanding of the condition, We need more awareness out there in every state about CRPS/RSD along with other terrible, debilitating, painful diseases. Even a dog isn’t usually allowed to suffer. We’re quick to go & help & aid a poor sick animal but sometimes there’s no compassion 4 a person that’s suffering in chronic, uncontrolled, unbearable pain…my heart goes out 2 each one suffering. Prayers!

  3. laura marie cantrell at 8:02 am

    prayers and hugs for u joe i am saddend that there are too many people taking there own lifes ~i am in reno nv have rsd i had back surgery 2 summers ago s1-l5 l5-l4 fusion and had to stop seeing a dr i saw for 10 yrs because i was only recieving medicare at the time instead of having my ins from work then the dr i saw for 2 yrs after my gallbladder surgery 2 months ago my reg dr sent me to pain managment ~ i have had chronic pain for 15 years i have never til know have experienced such similar things in this story and have seen this in others dr’s are dropping patients everywhere in chronic pain etc ~ i went through withdrawls for the whole month after my emergency gallbladder surgery with no pain relief and yeah u can say suicidal thoughts i have seen it in others my best friend died in feb after her surgry she was in so much pain for years and its a shame what others are doing to get “high” on are making legitamate people in chronic pain myself included to suffer and go through the HELL we have to sometimes i want to ask everyone here to please if u are on facebook there are a few support groups and they were the ONLY thing that helped me when i had to go through this ~ 2 months i went without my normal meds and NEVER want to go there i am know seeing dr lewondowski he is the best and i want to suggest to everyone here his book the chronic pain care workbook ~ i pray no one else has to go through this it is a horrible experience to go through and thank u everybody for your posts i really am glad that there are others out there who care 🙂 to write it does help others who are in the same situation to realize they r not alone we have to stay strong and win this battle so that others do not have to suffer i want to urge everyone to please take a stand and do not let this happen to u or others u care about and to the many others who are doing this alone we are the strongest people to have to go through this and have to be examples to others so that they can make it its taking me alot of years to accept this and well know its all i know good luck to u everyone

  4. Faith Rosenzweig at 9:46 am

    what I just read above about Michelle Malone has saddened me greatly. My husband has RSD and has had the symptoms like Michelle for over 9 years now. He is on opiods that quite frankly if I took the amount that he does to keep his pain in check (which most often it does not)….I would be dead from an overdose. To live with the anguish and pain that my husband does, I give him alot of credit for not taking his life. He has had these suicide thoughts in the past and I constantly have to give him my optimistism to keep fighting, not just for both of us, but for our kids as well who are 28 and 26. RSD is a devastating dystrophy and he was treated with the “suppossed best” doctor in our country ~ who was dismissed as a patient because there was nothing more that Dr. Schwartmann here at Hahnemann Hospital in Phila., PA could do for him. He relies on pain management here in Langhorne, Pa. but this doctor will not recognize medical marijuana because unfortunately it is not legal here yet. I just hope that within the coming years it will be and it won’t be too late for my husband physically and mentally.

  5. Celeste Cooper at 8:20 am

    This war on legitimate pain managment will drive the pain community underground, in more ways than one. We must take back our right to choice, and physicians should be allowed to treat and relinquish the government induced, uninformed frenzy. Police work should be left to law enforcement and pain care to physicians. Not all patients have the ability or finances for expensive pain clinics. Who knows the patient better holistically than the primary physician? Why are they criminalized for caring for their patients? Something is gravely wrong with our system.

  6. Erika at 10:31 am

    Another excellent column. Thank you, Mark Maginn.

  7. Ed Pane at 2:02 pm

    I offer my deepest condolences to Joe Malone. I know the grief of losing a wife to a disease with intractable pain. There is nothing but time that can heal the loss. The circumstances of being denied needed medication made Michelle an innocent victim on this utterly foolish approach to regulate and control medications. I am a professional substance abuse counselor and we as a group clearly understand the need for ample pain medication. Florida wasn’t made safer by depriving her and others in need of the palliative care they need.

    I am also a board member of Pennsylvanians for Medical Marijuana. Through that organization I met another Florida resident, Irv Rosenfeld, a stockbroker from Fort Lauderdale. Irv is one of only 4 people left in the US still getting marijuana from the federal government under its compassionate use program from the 1970’s. Irv suffers from two painfully debilitating chronic medical conditions. The drug has managed his symptoms, lowered his need for other pain management prescriptions, and frankly kept him alive. Today he is a national advocate for medical access.

  8. Bridgette Berner at 8:04 pm

    This is so sad yet so undoubtedly true for so many, my aunt did the same thing years ago. I now have to suffer and cope and I am told that the withdraw symptoms are even in my head! These politicians need to back away and stop trying to go out and save the day. They have no idea what we are going through if only Michelle God rest her soul could have switched bodies with one of them for a day I am sure this whole situation in Florida would be so turned around! All we have is each other and I thank God for Facebook at those all damning hours and for Donna and the others online that understand and know without even going into details what I am trying to cope with. Oh and one other thing it is absolutely ridiculous that emergency rooms have the nerve to tell people if they are drug seeking ir to tell you they have you flagged yes flagged is what I have been told when my medicaid was taken away on accident and I went to the ER twice in one month! Too many people with badges are running around thinking they know everything and can judge everyone what ever happened to not throwing stones at glass houses?? I pray everyday that each one of us gets the help we desire I know Florida is just teaming with people knocking at deaths door due to this incontinence of care.

  9. Wendy Burnett at 4:24 pm

    Joe has my heartfelt sympathy for his pain, and the rage of knowing that his wife would be alive if she hadn’t been totally failed by the system that was supposed to take care of her . . . I also fully understand why Michelle made the choice to end her own life, since I also live with a chronic pain condition, and am unable to get treatment for it. I’ve been lucky enough to find alternatives that have helped me, and most of the time I can keep my pain at a bearable level (between 5 ans 8 on the standard scale,) but if and when it gets so bad I can’t manage it with the methods I’m using now I will also opt out if I can’t get find a doctor willing to provide adequate treatment.

    The current climate of fear among laypeople, and the opiophobia of so many doctors and healthcare workers, combined with the DEA’s persecution and prosecution of any doctor willing to provide appropriate pain management for patients has led us to this point. If we, as pain patients; don’t stand up and fight for our rights, demanding that the politicians and law enforcement stay OUT of the doctor/patient relationship; the torture and misery will only continue and get worse.

    What makes me the angriest is that most of the hysteria has been caused by inaccurate, sensationalistic reporting; combined with statistics twisted to support the idea that patients are being killed by irresponsible doctors. In many cases, deaths reported as being overdoses of opioid medications are actually caused by combining those medications with alcohol or other medications. In other cases, deaths are determined to be opioid-related simply because someone had been taking prescribed pain medication at the time of death, even though death was actually caused by something totally unrelated to the medication use. In addition, deaths due to illegal opioids like heroin are also included in these numbers, skewing them even further. This twisting of the facts gives a totally false impression of the actual rates of death due to opioid use, and supports the DEA, politicians, and “addictionologists” in their claims. (There is one particular addictionologist, who shall remain nameless; that I would LOVE to see deal with the level of pain I live with every day with just the use of Tylenol as he suggests.)

  10. kimberly powers at 2:03 pm

    I also suffer from RSD i am in such pain at times and when i am on my third night of no sleep i can honestly see how this poor women had taken her own life.
    i live in philadelphia I too have trouble with the Doctors no one wants to be the one to right me a script for trammadol ..and i have gone to emergancy room and have been treated like all i want to do is get high …
    How do you tell these Doctors who are suppose to be helping you to HELP with the pain i am not looking to get high i am looking to at least be able to tolerate the pain …i know the pain wont go completely away but dam i would love to ease it up some !!!!! if anyone out there could give me suggestion feel free to e-mail me …
    i am so sorry that happened to you sir ….but on the other hand i know why your wife did that …..
    Thank you for allowing me to vent ….kimberly powers ….

  11. E11 at 1:54 pm

    I live in the same world Michelle and her family did; FEAR, DEPENDENT on a ‘HEALTHCARE’ System for ‘support’, and living in a society that has turned their backs on people in pain because of media hype and misinformation.

    I admit I have the same thoughts, and have gone as far (in recent weeks), to getting my ‘affairs in order’. I am waiting, every month to be either dropped from my Dr.’s practice (out of his own fear and intimidation from LE/DEA). I wait every month to see how many hoops I have to jump through when time to fill my prescriptions. I am tired. Like so many others. The last six months (over 12 years living with chronic pain, and yes I have tried every therapy offered or researched) of living in constant fear that the ONLY lifeline is about to be YANKED away, at ANY MOMENT. For so many, it already has. My back-up plan? Well, just this last week I finished shredding my journals from the 90’s…and making sure things are where they need to be, and even letters to my (young) children, explaining. Explaining, I am so damn tired of explaining myself, to everyone. ESPECIALLY in the healthcare field who are SUPPOSED to be the ones standing up for me.

    Well written article; I imagine this article will strike a chord with many chronic pain patients. We may not want to admit it, but we truly understand Michelle.

  12. Robert M. at 1:53 pm

    Thank you for this , i have had RSD for the last 15 years and live in Tn and am planning a move to Florida in the next few months but this has me a little worried now, i had lost my pain Dr. a year ago but my family Dr. has been kind enough to keep up my pain meds but he agrees i need a specialist in RSD as im haveing more problems and i do feel better when im down in florida and a lot better in the colder months, i have talk to a dr that will see me but only after i become a resident by getting my drivers license and a addresss there but now im not sure what to do ,, but thanks

  13. Jeanne Hyatt at 12:00 pm

    It is with deep sadness and yet, true empathy, that I read this account of this awful, awful tragedy. My heart goes out to Mr. Malone and Michelle’s family. What a beautiful life snuffed out because of the lack of foresight and lack of compassion by those who pledged to “First, do no harm”. Pain does this to people. Pain will make that choice for you. To just make the pain go away. I’ve been close to choosing relief in this way. I’ve been told I was “non-compliant”. It’s hard to comply when you are sick. It’s near impossible to jump through the hoops to be “the perfect patient” when your body is screaming in pain. Stop the inhumanity, now!

  14. PJ Marks at 11:43 am

    Thank you for this article. It is hard enough living with chronic pain, then the moral objections of some doctors and lawmakers makes those of us who need pain management look like addicts. It is barbaric to allow people to suffer like this.

  15. Raising Our Awareness of RSD at 11:32 am

    Watching someone with this disease is almost as bad as having the disease itself. It is that overwhelming feeling of helplessness that really drives the knife through your heart. To Michelle’s husband, our deepest sympathies. We have watched our mother slowly deteriorate from this disease for the last 7 years, we understand your frustrations. Our condolences to you and your family.

    To the author of this article–THANK YOU! Thank you for FINALLY shedding some light on this ignored disease!

    Respectfully,

    R.O.A.R.
    Raising Our Awareness of RSD