By Safe Call Now Admin
What is chronic pain? The word “chronos” is actually derived from the Greek word, Chronos, which means, “time” and “year.” According to WebMd.com, chronic pain is a condition that lasts longer than six months.
There are two types of chronic pain. There is malignant chronic pain, which usually is a symptom of cancer, AIDS and other severe illnesses. People who are in the final stages of a terminal illness are often given narcotics, including morphine and methadone to help make them a little more comfortable. Addiction is not as high a priority at this stage of the game. The key is to make the terminally ill client at ease during a difficult time.
For the purpose of this article, we will focus on non-malignant chronic pain. Non-malignant chronic pain includes arthritis, fibromyalgia, lupus, migraines, carpal tunnel syndrome and a plethora of other medical conditions. For people who suffer from these conditions, the pain never appears to go away. Treatment can get very tricky, as well.
Chronic pain can be nonstop in its nature, or it can come and go. Sometimes the pain is mild, and other times the person suffering from chronic pain will be in agony. It all depends on the individual, and the medical condition causing the pain. What’s worse is that for those with non-malignant chronic pain, there appears to be no light at the end of the tunnel. Often their pain can last for years.
Many times these individuals go to doctors who often prescribe painkillers, which are usually opioids. Often the physicians will give them refills, because the doctors are perplexed! They can’t seem to find the root of the problem! So medicating their clients seems to be the way to go.
There are two types of opioids prescribed for those suffering from chronic pain. There are opioids that give immediate relief, as well as opioids that take longer to provide relief.
Short-term opioids include hydrocodone (with acetaminophen or Ibuprofen), codeine and oxycodone (prescribed alone or in combination with aspirin, acetaminophen and/or ibuprofen).
The short acting opioids make the clients feel as if they are on a rollercoaster ride. One minute they experience an exhilarating sensation of liberation from the pain, and then suddenly, after a few hours, they crash and are trapped back in the clutches of the horrible agony.
This rollercoaster effect causes major anxiety in the person. Also, when a person gets a twinge of relief from chronic pain, it’s almost like the exuberant feeling a starved person experiences when they finally get a plate of food. They just don’t want to stop eating, and what would they do, if some cruel human being appeared, and grabbed their plate, just before they took a bite?
They would lose their mind.
Well, that’s probably the same feeling that a person who suffers from chronic pain gets when they receive relief from an opioid and then suddenly, a short time later, the relief is literally snatched from them, only to be replaced by the hellish pain.
Chronic pain sufferers often end up taking more of a higher dosage than prescribed. Within the time span of two weeks, they will become addicted to the painkiller. Also, their bodies have developed a tolerance for the painkiller, and require a higher dosage! And in many instances, the pain gets worse. This is because the painkillers wreck the nerves that are attached to the pain receptors in the brain. The painkillers cause the nerves to become more sensitive to pain.
This condition is known as “opioid-induced hyperalgesia” (OIH).
It’s an ironic condition because in the end, the painkillers cause more pain!
According to several doctors featured on American Chronic Pain Association videos, long acting opioids are preferred to short acting opioids when it comes to treating chronic pain. Apparently, these opioids are formulated on a controlled-release basis, and the pain reduction effects last between 8 and 12 hours. Typical medications include morphine-controlled release tablets, oxycodone controlled release tablets, and buprenorphine and fentanyl transdermal patches, which are actually placed on the person’s body, much like the nicotine patch.
Additionally, methadone, which has traditionally been used as a maintenance drug for heroin addicts, is used as a long acting painkiller for chronic pain sufferers. Apparently, methadone targets a specific receptor in the brain. However, methadone, like other opioids has a very dark side. Methadone interacts with certain foods, and other medications. Sometimes if one doctor prescribes methadone for the client, and then a psychiatrist prescribes a certain psychotropic medication without being aware that the client is on methadone, the result can cause death.
Other potential negative side effects include arrhythmia, which is an irregular heartbeat. That can cause death, as well, if the person takes more than the prescribed dose of methadone.
And like other opioids, methadone builds tolerance.
Using opioids to treat chronic pain, often leads to drug addiction. And what’s a bit frightening is that this is a major treatment protocol for chronic pain. It’s almost as if the doctors give up trying to find a permanent solution for the pain. It’s actually easier for them to prescribe pills or patches, and send the client on his or her way. But sometimes the truth is that the doctors cannot figure out what is going on! Chronic pain clients will often travel from doctor to doctor, in the hopes of finding answers, but often leave with prescriptions for painkillers in their hands.
And chronic pain clients often abuse alcohol, as well as other drugs.
Once clients develop a drug addiction, it’s challenging for those who try to help them become clean.
During the roundtable discussion, Dr. Robert N. Jamison, a Doctorate-level psychologist, said that many chronic pain clients are often “unwanted” by clinicians. But the best solution is for them to find a team of health care professionals including mental health and physical health providers that will help them. And those health care professionals are out there.
Alternatives to opioid therapy include holistic therapies, cognitive behavioral therapy, and exercise.
It’s not an easy road to take, but chronic pain clients who get addicted to opiates become very depressed. Their lives lose meaning. And often the depression infects their families, because chronic pain clients are obsessed with their suffering. And sometimes all they do is complain and drive their families insane, as well as themselves.
The best option that chronic pain clients can do is to find a good treatment program and also a qualified medical facility that will help them find better and healthier solutions to their pain. This will help them lead meaningful and happier lives.
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I’m a former paramedic with PTSD and Depression. Emotional Pain and Physical pain often go hand in hand. It’s a mess of a combination of conditions when one legitimately suffers from both physical and psychological pain. Dr. Gabor Mate, an expert on trauma and addiction in Canada, suggests often in his work that physical pain can lead to emotional suffering, and that emotional suffering can find it’s way out of the body via physical pain signalling.
Not only are my mental health issues, PTSD, Depression, and Substance Use Disorder the result of traumatization due to the work and exposure to traumatizing events across the course of my employment:
I found myself in a state of what seems like accelerated aging. This was attributed by my helpers as being due to high-levels of stress hormones, cortisol, adrenalin, and noradrenaline in my system, which broke my physical body down more rapidly than might otherwise have been lived over time.
I ended up with my vision messing up first of all. “Central-Serous Retinopathy”. The ophthalmologists I saw to help me correct a blind spot that developed initially confirmed a relative connection to high-levels of epinephrin) and noreinephrin, which is implicated in CSR patients. The physicians indicated to me that they see this condition often in high-stress-driven adrenalin-junkies. Those we might consider as having, “Type-A” personalities.
The next issue that came on over time: My hips broke down, ultimately demanding full-hop replacement bilaterally. I was first in trouble psychologically in 1994. That was my first clinical bout with depression. By 2005, I’d failed to continue working as a paramedic. By 2007, my hips started nagging me. I was prescribed Tylenol with Codiene. Then Tramaset (Tylenol/Oxy). I turned to street-drugs to calm my PTSD symptoms and depression. Eventually becoming dependent and addicted with cocaine and oxycontin as I waited to find right treatment for my mental health struggles and for my hips.
I ended up in a real mess. There was really little available to treat PTSD. Surgeons initially wouldn’t touch my hips as I was considered too young in 2007/08/09. I had my first hip-surgery finally in 09/10. I was by then, only 47 years old. Much too young to be in a mess with my hips. If osteoarthritis is in anyway genetic: My Mom is only now suffering such things and she’s nearly 80.
By the time they agreed to finally replace my hips, I was a full-blown junkie on all that I’d used to help me manage both the emotional and physical suffering.
It took another four years to complete both hip-surgeries. One-at-a-time. In 2013, I’d failed at other work, my hips were done and replaced, and it was only then that I found right PTSD and trauma help. From 2015 forward, it’s been a situation of remission of my PTSD, Depression, and Substance Use issues, followed by relapses, recovering to remission again, falling, getting up, and on it goes.
I no longer care if I slip with Substance. I no longer allow my depression to drive me to suicide (which I survived in 2015). I no longer believe the lies PTSD and Depression hope to tell. I no longer accept stigmatization from myself or anyone else for any over my mental health issues.
My hips? 100%. Use of opiates? There’s no physical pain lingering that I can’t manage with Tylenol or Advil alone. Which is rare frankly. The last Tylenol I took was for a headache.
Substance?
I turn to that, and I’ve informed my physicians and family that should I lose my way, relapse, oh-well. There’s so much to learn to overcome PTSD and Depression alone that I refuse to battle against taking the equivalent (1/2 -1 gram of cocaine) from time-to-time to restore cognitive functioning should I lose that. Which, for me, is far more intolerable than using a drug like cocaine in an amount equivalent to two, Extra-Strength Tylenol (also 1 gram of Tylenol-as-a-Drug).
If I can’t think, then I end up in a real mess. Much more a mess than I find myself in should I use cocaine, which too, now, is rare.
I share it simply to support the findings shared here. And, to open-up in a way that might be heard by others from Public Safety Professions in the same boat.
It all ends up generating a very complex set of chronic conditions when we end up in emotional struggles. Emotional struggling and high-levels of stress hormones flowing in our systems is unhealthy on it’s own for the Adrenalin-Junkies among us who love the thrill of Code-Three calls and the like.
Add trauma issues to the mix?
It’s a perfect storm often of self-destruction. Most of which will remain outside of our conscious control until we meet-up with those ‘right’ trauma-informed helpers who can guide us towards more healthy ways to manage both physical and emotional, chronic pain and suffering.
The drugs have a purpose. For chronic pain there is often, for many, no other evidently available options from which to make any conscious choices than but to accept opiates for physically debilitating pain.
I worry that as we become so highly charged with the opiate epidemic under way, we’ll forget that often, for many:
These opiates are all they have.
“We ask, ‘Why the Addiction?'” “What we should be asking is, ‘Why the pain?'” ~ Dr. Gabor Mate
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Thanks for addressing the issue of chronic pain. It’s just one of the many side effects of being a first responder that many people do not realize if they are on the outside looking in.
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