Prescription opiates are the devil. Opiates are also saviors.
Opiates have shown me rock bottom and given me a chance at redemption.
I am in the unique and unenviable position of being both a recovering addict and a chronic pain sufferer. I injured my lower back in 2005 due to my service as an Army helicopter pilot.
My back pain started out innocently, when I first stepped foot on the moon dust sand in Iraq. After a year wearing flak vests, combat boots and Kevlar helmets, I developed searing, shooting pain down my left leg, like someone was stabbing me with a knife over and over.
As a Captain in charge of 11 American soldiers in a remote area, I could not leave my soldiers to take care of myself. The military has an ethos to “suck it up” for the good of the unit. I expected to be rewarded with exemplary medical treatment upon my return home.
The first flight surgeon gave me a precursory exam and said this stinging sentence: “Pain is part of life. Suck it up.”
As a female Army officer, helicopter pilot and endurance athlete, I thought I was mentally and physically tough. I earned 12 varsity letters in high school and ran triathlons for fun. I identified with anything athletic and active. After each failed surgery or pain management procedure, I desperately tried to stay positive but eventually lost hope.
In one year, I went from being a vibrant young woman to a miserable lump on the family room couch. I ate junk food and watched a continuous loop of “The Golden Girls.”
Abusing a prescription that increases the dopamine pathways in the brain seemed more of a survival technique than a problem at the time. I knew that taking more than the doctor prescribed was against my “narcotics contract.” I justified it by rationalizing that the doctors weren’t holding up their end of the contract, either.
I felt an infinite black hole sucking me in and the pills made me feel human again.
I knew what I was doing was not only wrong but could not be sustained. I was lying to my doctors, my pharmacists, my family and friends. I didn’t want anyone to know that I was misusing my medication or how dreadful I felt inside, so I used jokes as a defense mechanism to hide how I felt.
I would run out of medicine early and try to tough out the withdrawal symptoms before my next doctor’s visit. But you can’t hide the sweating, chills, nausea, diarrhea, irritability, insomnia, muscle cramps, and the “heebie jeebies.” You feel like you have the flu for everyone in the U.S.
Usually I would beg for mercy by scheduling an early appointment with my doctor and then charm and/or con my way into an early prescription. Ditto the pharmacist. I wasn’t trying to get high — I just felt so hopeless about the intractable pain that I would do anything to feel better.
After a while I couldn’t handle the dishonesty or the dope sickness any longer. I got clean and got the mental health treatment I needed. I was on Suboxone for several years to help my pain, but eventually was put on a Fentanyl patch. The patch is designed to release small amounts of Fentanyl every hour and should last 3 days.
For an addict with an obsessive mind, this is an ideal solution. You don’t have to think about your medication for days! It worked great until those patches wouldn’t stay stuck to my skin. I’m overweight, I sweat and the patches fall off. Not sticking is a well-documented problem with the Fentanyl patch. I tried every tape or bandage CVS, Walgreens and Rite-Aid offered.
Suddenly, finding the perfect medicine was becoming another obsession. In North Carolina I had an ideal setup with an understanding doctor and pharmacist. I tried other medications with uncomfortable results: Opana ER made my heart race; Morphine made me sleepy; OxyContin was off-limits and others just didn’t work.
We moved to California in March, abruptly destroying my pain management oasis. I discovered that the opiate paranoia was in full neurotic force in the Golden State. First I had to find a doctor who would prescribe it and then find a pharmacy that 1) kept it in stock and 2) would dispense it without some unattainable guideline.
This time I was trying to take the medicine as prescribed, but worrying about the patch triggered memories of my old destructive habits. I wanted to get as far away from that experience as possible.
One hot, sunny day in California I reached my breaking point. I had dragged my 2-year old son to 5 pharmacies with no success. I was angry, frustrated and exhausted. I drove straight home and called my husband: “That’s it. I’m done. I’m going cold turkey off Fentanyl starting right now.”
My sincerest desire for the past year was to wean down from Fentanyl as far as I could tolerate. I had a grand plan: 1) Lose 100 lbs. 2) Strengthen my core 3) Get myself off the patch.
I craved sweets and junk food while on Fentanyl, making it more difficult to lose weight. Plus, I felt like my emotions were not my own. Part of why different opioids work is because they influence the brain’s creation of dopamine. I worried that I’d never produce my own dopamine again. If my son giggled or did a million other things during the day that made me laugh, I wondered if those emotions were genuine.
For me, getting off the medicine was worth a try. California pushed me over the edge.
Withdrawal sucked like it always does, but I was a woman possessed with determination. It has been 3 months since I last put on a Fentanyl patch and surprisingly, my pain is bearable. My emotions have been up and down and all around, from the dark “don’t want to get out of bed” depression to general anxiety and irritability. My husband is a saint. I know from learning about addiction that these emotions are my brain’s way of healing.
My brain is now free to create the greatest form of therapy for me: Stand-up comedy. I use comedy to battle all the most frustrating moments of my past. I hope one day all of you will be sitting in an audience where I’m performing.
Please laugh at my pain.
I will perform for you if you take opiates or not. The way we each manage our pain is an incredibly personal decision. We have to fight for each other to keep the effective tools available and create more “saving graces” for better pain management.
Darisse Smith lives in California with her family.
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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 represents 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.