Painkillers and the Persisting Issue of Overprescribing

I try to make it known that I am in recovery for alcoholism before the exam even begins. I’ll usually slip it in somehow, trying to find a good, natural opportunity without seeming over-enthusiastic or suspiciously eager to expose my past. (I still second-guess myself on a pretty regular basis – especially when it comes to discussing my reasoning behind just showing up in Florida one sunny, summer day.) Usually the doctor will ask me some stupid personal questions, and I’ll be able to interject with something along the lines of, “I’ve only been here two years, I came from California to get sober.” I was told early on that medical professionals should know these kinds of things, so that they don’t accidentally prescribe you a narcotic medication that could ultimately take your life. It’s a real practice in integrity. And of course the thoughts cross my mind on occasion, of course they do – I’m a fucking alcoholic for crying out loud. No matter how much clean time I accumulate, I’ll always be an alcoholic. And even though pills were never my thing, I can easily think back to the academic benefits of a good dose of Adderall and convince myself that maybe talking the doctor into filling me out a quick scrip would do wonders for my work performance.

Once an Alcoholic, Always an Alcoholic

I recently underwent some significant (in my eyes, but I’m still a bit of a drama queen) medical issues, experiencing inexplicable abdominal pain so severe that I had to leave work midday, doubled over. I drove myself straight to a crappy little local urgent care facility. Being a Southern Florida transplant (like most of us recovering folk), urgent care has always been a safe bet. They accept insurance, they work relatively quickly, and they seem to prescribe something at least effective enough to get the job done. Tracking down a primary care physician is such a drag… all of that paperwork, the phone calls – talk about delayed gratification. No thank you. So off to urgent care I went, tears streaming down my face as I puffed on what I believed may have been my last cigarette.

I actually wasn’t smoking, I just added that in there for dramatic effect. Conjures a pretty good, sympathy-inducing visual, right?

“How Badly Does it Hurt on a Scale of One to Ten?” Here’s Some Hydrocodone

I was the only patient in the facility, so I was seen almost immediately. The doctor poked my stomach a few times, tapped on the bottom of my foot, and asked me how badly it hurt. “Badly,” I told him. “It hurts a lot. Like… a 9.” There are several issues with the good old ‘1 through 10’ pain scale. Firstly, the patient is completely responsible for expressing the amount of pain he or she is in – what to me is a 9 may be, to others, a solid 6. And even if I was at a loose 3, I could have screamed ‘10’, potentially resulting in a remedy much more intense than a little Tramadol shot to the butt. The ‘word of mouth’ system may work swimmingly for some, but for those of us who have made a career out of manipulation and mendaciousness, something a little more thorough and legitimate would certainly seem a wiser option.

Long story short (or is it too late), the doctor prescribed me some antibiotics and an emergency CT scan – along with a 30-day trial of Hydrocodone. I’ve written enough about the stuff to know that this is a narcotic opioid analgesic; one that is both highly addictive and not recommended for those of us attempting to sufficiently recover from a devastating chemical dependency issue. Although I know that the doctor was good-intentioned and meant no harm, I was slightly offended by his brashness. But that’s my own shit. I wish I could tell you that I politely said, “Thanks, but no thanks. Opiates are bad. Good day to you, you ignorant doctor man.” In actuality, I filled the prescription, called my sponsor and talked to her about the implications of painkillers and relapse for a solid half hour, and decidedly flushed the little suckers down the toilet. Progress, not perfection.

Instant Gratification and the ‘Quick Fix’

For those of us in recovery, finding a general practitioner with adequate experience in the realm of addiction is absolutely key. Over the course of the next couple of days I visited many more doctors for many more tests, and was shocked to find the lack of knowledge regarding addiction and recovery widespread and blatantly obvious. One of the most valuable lessons I have learned during my own personal journey of recovery is that there is truly no such thing as a ‘quick fix’. You can slap a Band-Aid on an infected stab wound, and while you may be saving the public from viewing the offensive, seething sore, you will still be quite injured whenever you choose to rip that Band-Aid off. Pain medication will help ease the pain, undeniably – but that’s all it will do. And only temporarily. Not to mention you may very well be opening the door to a slew of other, even more unmanageable, issues. Such as waking up 10 days later in a gutter somewhere in Newark, wearing nothing but a mink coat and combat boots. Where’s your cellphone?

Harsh generalizations sometimes get me into trouble, so I will be sure to mention the fact that some doctors who lack a specialization in addiction certainly know enough about the world of recovery to treat their patients accordingly. However, if you are a transplant like me, I absolutely advise you (from personal experience) to consider seeking out a primary care physician with a personal background in substance dependency. Just something to consider. While laws and regulations regarding narcotic painkillers are now more harshly implemented than ever before, nearly 17,000 Americans lose their lives to prescription pill-related overdose annually. Overall, there has been a 3.4-fold increase in the total number of opioid painkiller-related overdose deaths from 2001 to 2014. It is currently estimated that an average of 44 individuals lose their lives to painkillers on a daily basis. 44 deaths every day.

44 Americans Die of Painkiller-Related Overdose Every Day

There are other options as far as safe and effective pain management go. Overprescribing narcotic painkillers has been a major issue throughout the medical community for quite a few years, and while Prescription Drug Monitoring Programs (PDMPs) and other preventative measures undoubtedly make a difference, rates of painkiller-related deaths make clear the fact that the issue persists. If you are in recovery and wish to remain in recovery, being open and honest with all medical personnel about your personal struggles with addiction is essential. However, many individuals throughout the medical community lack proper training or extensive knowledge when it comes to substance dependency; therefore merely explaining your circumstances may not be enough. Take it upon yourself to find a doctor with extensive experience in the realm of addiction, and do yourself the favor of finding a primary care physician that you like and trust to see regularly over the course of your stay (wherever you are).

Physical Health is a Key Component of Addiction Recovery

Addiction recovery is a comprehensive journey, one that focuses on the restoration of spiritual, mental, emotional, and physical health. While we tend to spend ample time honing our spirituality and our emotional wellbeing, we sometimes neglect the physical component of our overall healing process. Take care of yourself to the very best of your ability; not just by means of daily meditations, yoga classes, 12-step meetings, stepwork, psychiatric appointments, and therapy. But with regular physical exams, daily exercise, adequate nutrition, and obtaining a reputable and experienced primary care physician to visit if the need ever arises.