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Friday, January 25, 2013

A 12 STEP ANONYMOUS PROGRAM FOR THOSE LIVING WITH CHRONIC PAIN. REALLY??

I stumbled across this site * and could not believe my eyes.

The founder is a physician who has worked in the field of addiction medicine for 31 years.
He initially refers to chronic pain patients who have become addicted to pain medication.

Okay I am with him so far.

There is a minority of pain patients who will become addicted to narcotic medications. The number is higher for those who have a history of addiction. My problem is that it is not for those who have a combination of chronic pain and opiate addiction, but specifically for those who live in/with chronic pain.

He makes a direct correlation between those who are addicted to drugs, in general, and those with chronic pain. This is where he loses me.

His first of 4 similarities between those with chronic pain and those fighting addiction is "INTRACTABILITY."

"An addict never stops being an addict. For instance there is no such thing as an ex-alcoholic." Addicts have a lifetime fight on their hands. They need all the help they can find. Only the strong survive. The addict doesn’t want to hear this but that is the reality.
Chronic pain patients never get over their pain. Oh at times it is better but the pain is always there. Unfortunately it is a lifetime struggle. Their pain is intractable. Chronic pain patients do not want to hear his."

No one wants to hear whatever disease/disorder they have will be a lifetime disorder but unlike addicts, who have to deal with a lifetime of potential craving for their drug(s), I know of no one with chronic pain who craves their pain. (There are always the rare people, as with any group, who get a "benefit" from their pain. That is very far from the norm.)
Most of those with pain do not want to accept the intractable aspect of their pain. I surely do not, and have not for that matter. But most of us do not go to any length, no matter what it is, to get relief. We do not go into back alleys, we do engage in illicit behaviors to get treatment, we do not beg doctors to treat us, no matter what the cost.
There are also many with chronic pain who do in fact get over their pain. Surgery, treatment, medications can and do work for some. If and when it does there is no longer a fight or slide back into chronic pain.

Next is "PRE-OCCUPATION"

This shows a basic misunderstanding.

He writes "The alcoholic’s life revolves around alcohol. ... The addict thinks about little else other than the next drink of fix."

He goes on to state, unequivocably, "Chronic pain people are absolutely obsessed with their pain. “Pre-occupied” is too tame a word. Everything revolves around their pain. Their home, work and social life are severely affected by chronic pain and it is a lifetime sentence."

Being 'pre-occupied" is very different from working around the pain to create your day, your life. Our lives are severely affected by the pain. That does not equate to pre-occupation.

"LOSS OF CONTROL" is his next cross-similarity.

I need to use his entire quote: "The addict simply cannot control his or her drug use. The end result is trouble. There’s trouble at home, at work and there is no social life. For the active addict, the prognosis is always a downward spiral.
Chronic pain people lose everything too. Personal relationships go down the drain. Work life becomes a thing of the past. Social life becomes non-existent. There is no end to medical bills. Surgery after surgery, block after block, pain program after pain program and all result in disappointment and despair. Chronic pain people cannot simply get on top of their pain. They have to learn to live with it."

That we lose a lot is a given. That we lose it all: personal, work, social, is an indictment rather then a wonderment of the lives that many still claim, continuing to work despite horrendous pain, having spouses, children, relationships. Shame on him for not being able to recognize the fight that allows so many to continue to have good lives, deep relationships, in spite of the pain. By doing so they have learned to "live with it".

He also presupposes that we have no intelligent ability to say "No."; to treatments, therapies, medications. In a way it is applaud worthy, his getting an underlying truth: that pain is so incredibly hard to deal with, to live with, that one would want to accept anything offered. The other side of that truth is that, for the most part, we are educated patients, not exposing outrselves to any and all, because we understand the downside of many of the things offered.

He also has another lack of understanding in this comparison. "all (treatment, pain, medications, programs) result in disappointment and despair". That is an absolute fallacy. Many peple do find some form of benefit from their treatment(s). If you're lucky 100%, if less lucky, less then that, and very unlucky, a low or nil percentage. But he speaks in extremes and ignores a major part of the chronic pain population.

And his last "CONTINUED USE IN SPITE OF ADVERSE CONSEQUENCES." "Addicts are in trouble all the time", he writes. "...They can’t use with control, so use leads to abuse and trouble. An addict knows better intellectually but will continue to use. The end result is usually death. The terribly sad thing is that more often than not he or she drags those around them down with them
Chronic pain people follow the same pattern. I remember one patient who underwent over 25 major surgeries. When he was cut off prescription drugs, he drank a minimum of a fifth a day, often two. Post treatment, he was found dead six months later."

He uses an anecdote to make his point. An anecdote does not speak for more then the person spoken of in the anecdote. That is not to say the person he writes about is a singular story. It is to say that it is not the majority but a vast minority.

He ends this part of his article stating "Chronic pain people keep making the same mistakes. They keep hoping for some magical surgical procedure, some new medication, some miraculous entity that will take away their pain and who can blame them? The string of adverse consequences never seems to end. Sound familiar?"

I think he is right. Most of us do hope for that answer. He is wrong in that most pain patients do not stop their lives waiting for the magic bullet.

12 step programs have worked for millions, he wrotes. Absolutely.

Sharing of stories and experiences never hurt anyone, he says. Right again.

But, is there truly a one to one connection between those in chronic pain and addicts?

Only if you believe that those in chronic pain do not have a physical condition that often has stopped their lives in its track. Only if you believe that chronic pain is the result of environment and maladaptive behavior. Only if you believe that the majority of us have put our intelligence, logic, and comprehension on a back burner, accepting anything and all things that are offered to us without considering the potential implications and adversities that may make our pain even worse.

And why an anonymous program? I do not hide, usually, if I have diabetes, cancer, kidney disease, etc. Hopefully I let people know. I ask for help. They cannot offer if they do not know.

Society frowns on alcoholism, drug addiction, sexual, gambling addiction. Most do not declare it. It is a societal prohibition.

From this doctor's perspective, those in chronic pain should be looked on in the same way.
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6 comments:

  1. Carol, you really found a good one. This dude needs a glass stomach in the worst way!

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  2. This is veryscary. I am a recovering addict because I was overmedicated and then my kidneys failed. This is comparing apples ansd oranges. There is a doctor in my area that freely dsipenses heroin for fibro. I do not see him but somedays I need restful sleep so much to ease the pain.. After 18 years I finally got pain killers and muscle relaxers because I was taught if I did it was a relapse. It is not a relapse. I need some quality of life. I take a strong non-narcotic drug and Tnak Heaven my kidneys funtion without dialysis. I am truly blessed. I was diagnosed 20 years ago. at meetings, I am considered in active addiction.

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    Replies
    1. Thanks for writing.
      I am sorry that the medical problem led to your addiction. It is wonderful that you 20 years in and that non narcotics are helping you.

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  3. I think an addict at one time had a choice they made. Believe me I did not sign up for my pain.It was not because of a choice I made.

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  4. Anonymous. That is why I think the "12 step" program for pain anonymous is such a bad idea and concept.
    Carol

    ReplyDelete