My affair with opioids

I’m at the doctor’s office. It’s the second week of February, 2013.

She thinks the sharp pain in my ribs is from an ulcer. Probably the result of taking 20 to 25 Advil a day for weeks on end when I get one of my headaches.

I’ve been getting the headaches since I was in college, but all the doctors I’d ever seen had brushed me off when I told them I could put the pain at bay by taking a few simple Advil.

This doctor says they should have asked me a follow-up question: “How many Advil, exactly?”

So, yeah, the Advil is out. At least for now.

“But what if I get another headache?”

“Here. Let me write you a prescription for hydrocodone. Take one of these if it gets really bad.”

***

The headaches come back, but the hydrocodone does nothing for them. I start taking the Advil again and pray I don’t end up with a huge hole in my stomach.

But, the sharp pain in my right ribs just keeps getting sharper, and the Advil doesn’t even touch it. So I try to take the hydrocodone for that. Except they’re only 5 mg pills, so I still get no relief.

I fantasize about throwing the bottle against the wall in anger and frustration.

***

I find a new doctor to help with the rib pain.

It’s so bad I’m starting to seriously consider suicide.

“What’s your pain level?”

“Ten. I’m at a 10. It’s horrible. It hurts too much,” I tell him, with tears streaming down my face.

He writes me prescription for really strong Aleve.

It might as well be Skittles.

***

I’ve been suffering for months, and I start having unhealthy thoughts about chugging a bottle of Drano. Or slitting my wrists in the bathtub.

After a particularly horrific night, I decide to go to immediate care. I beg the doctor for help. She offers hydrocodone.

“I need something stronger. That did nothing for me last time,” I plead.

“Well, I can’t give you anything stronger than that in immediate care!” she balks, as she writes me a prescription for it anyway.

***

A few days later I’m at the pain specialist. I tell him that the hydrocodone doesn’t really help the pain, but it does take the edge off.

He turns and says to his resident, “If she wants hydrocodone, give her hydrocodone.”

I leave with a prescription for 120 10 mg pills, with instructions to take 1-2 every 4-6 hours as needed.

It doesn’t take long to figure out that the 10 mg pills are twice as good as the 5 mg pills. At first I start slow, taking one at a time and only if I’m in a lot of pain.

But then I pop one if I have a long day to plow through, and I’d like to pretend I’m just not sick.

Soon I’m popping them before work, so I can handle the drive.

Except it’s too early for that. They’re still making me way too high to get behind the wheel.

I end up on I-294 higher than a spaceship, unsure of what to do.

I’m too far away to turn back, too high to concentrate on the road, and still a good hour away from work. The only safe option is to pull over somewhere and let the pills wear off — but that could take hours.

I decided to just go slow and get to work.

By the time I get to the parking lot, I’m sobbing from the meds, the traffic and from being so high. I pull myself together, wipe off my tears and go to work.

By lunch, I’m popping another hydrocodone. I have to get through the day.

***

For too long I try to maintain my two jobs. But it requires handfuls of hydrocodone to do it.

“I can teach the evening class, but I’m going to have to take some hydrocodone first,” I tell my boss. He doesn’t care.

Before I got sick I was so Type A that nobody wanted to accept that I might not be able to do everything for everybody anymore — least of all myself.

Even with all the pills, I’m still nowhere close to pain free.

Things start to slip. I’m barely showering. And I’m relying way too heavily on dry shampoo.

I’m skipping any extra duties at both jobs that I normally would have done without even being asked.

And I’m barely talking to my boyfriend.

Then, one night, he gets tickets to a Cubs game. I want to go so bad. I want to maintain the life I once had. I want to pretend nothing has changed.

So I take two pills this time. For the first time.

Two 10 mg hydrocodone pills.

I mean, the bottle says I can take 1 to 2, right?

It’s one of the best nights I’ve had in a long time. I can almost remember what it’s like to be healthy.

I want more of that.

***

I’m sitting on the exam table about to be fondled by a man I’ve only just met. They’re trying to rule out breast cancer.

All I have on is my underwear and a flimsy paper hospital gown.

He examines my breasts. “They look healthy,” he says.

I didn’t realize that you could tell if breasts were healthy just by looking at them.

“So, they really don’t know what you have?” he asks.

“Nope. I just woke up one day with horrible pain on right side.”

“Hmm, well either it’s a nerve problem or…”

“Or what?”

“Or you’re a really great actress.”

“Huh?”

“Well, I mean, you could just be acting so you can, you know, get the medications.”

I’ve never even smoked a cigarette in my entire life. And, yet this man I just met is trying to feel me out and see if I’m just another addict.

“Ha. Ha,” I laugh nervously. “I’m not. The pain is real.”

“Oh, yeah, I’m not saying it isn’t.”

Umm, you kind of just did.

***

If two pills worked so great for the Cubs game, maybe it could work well for the other parts of my life.

Suddenly I’m going through 120 10 mg hydrocodone pills in 17 days.

I’m totally unaware that this could be seen as a problem. As far as I’m concerned, I’ve finally found something that might actually help me live my life.

When I call for a refill the nurse is shocked. And very angry.

“What? You’ve already gone through the whole bottle?”

“It says I can take 1 to 2. So I took 2.”

“Okay, we’ll give you a refill this time. But your next dose has to last the whole 30 days.”

***

Feeling better is addictive in the same way that not being hungry, not throwing up, and not getting hit by a semi-truck is addictive. I want more of it.

The 120 pills don’t last me the whole 30 days. I’m a few days shy. But I can tell from my last encounter with the nurse that I’m not allowed to call for an early refill.

So instead, I figure I’ll just stick it out. How bad could it be to go a few days without hydrocodone?

Except when you go from taking as many eight 10 mg hydrocodone pills a day to zero, you feel like you’re dying.

Then you feel like you won’t die soon enough.

All my bones feel broken and I have insane diarrhea. I can’t think straight and the pain in my ribs is even worse than usual.

I turn to the over-the-counter meds, swallowing handfuls of Tylenol and Advil trying to ease the pain. Eventually I fall asleep.

As soon as I get my refill, I pop two hydrocodone immediately. My body has been through hell in the last 72 hours. I’m craving a sense of peace.

“Thank God for hydrocodone,” I say.

***

The problem with hydrocodone is that it’s a quick-release drug. You get the initial kick of pain relief, and then it completely wears off before your next dose.

Within about four hours you go from getting the precious pain relief you crave to feeling like you should be flown to the closest emergency room.

I figure there has to be a better way. So I go to my new doctor’s office to discuss options. Long term options. Options that come with a drug contract. The kind requiring a blood signature and your first born.

I’d sign over my soul if it meant I could feel better.

The doctor suggests morphine.

It’s a time-release capsule that I can take three times a day, so I won’t have to endure the insane highs and lows that come with hydrocodone.

“It sounds great. Let’s do that.”

***

The first weekend I’m on the morphine is Thanksgiving. It knocks me out cold. I sleep for four days.

Eventually, though, I get into a rhythm with the drug.

But, although I don’t have to endure the lows of hydrocodone, I also don’t get the highs.

So I never quite get back to my favorite place — that place where I can almost remember what it’s like to be healthy.

***

A few months later, I’m back at the doctor.

I draw him a little chart. On the bottom it says suicidal, and on the top it says functioning.

Then I draw a line right below functioning to show where I can get with the morphine. It helps, but not quite enough.

“I’m still in too much pain to get off the couch most days,” I tell him. “And if I have breakthrough pain, the morphine doesn’t even touch it.”

“Well, how about we give you some hydrocodone. Just some 5 mg pills you can take to supplement the morphine.”

“That’s exactly what I was hoping for.”

***

So why am I telling you all of this? Well, mostly because it’s true and I’m a writer, and there’s this part of me that has to get it out there, because it’s the only way I know how to make sense of things.

But also because it’s true and yet so few people are talking about it. People are in chronic pain, and they are on opioids, and neither of those things are a black and white issue.

Being in obscene chronic pain on a daily basis changes you. It’s like someone is sticking their hand inside of your heart, and ripping apart your very soul and turning you into a different person.

Like most people, I was pretty anti-change, so when I first got sick I made every effort I could to avoid it — mostly by swallowing as many pain pills as I could manage.

In the beginning the doctors handed them to me like they were after-dinner mints. I barely even had to ask for them. And nobody took even a one single minute to explain how addicting they can be, how quickly your tolerance can build up, or how careful I needed to be with them.

I mean really? The doctor was giving me hydrocodone for headaches? There’s so many things wrong with that scenario.

And, I honestly didn’t even realize hydrocodone pills were opioids until about four months after I started taking them.

I’m at the doctor’s office, carrying around a clear Ziploc bag full of all my pill bottles so I can show them exactly what I’m  taking, and the nurse turns to me and says, “Do you have any opioids in there?” And I honestly say, “I don’t know.”

“Well if you do, you should probably put that in your purse. You just never know with some people,” she tells me.

It was only then that I realized I might have some pretty strong stuff on my hands.

The thing is, without the opioids though I truly believe I would be dead by now.

Chronic pain eats away at you, and it takes away all your hope and all your optimism and all the good things you have inside of you. It’s constantly there, asking you why you even bother to keep going when you know you’re just going to have face another day today that was just as awful as yesterday?

Except, sometimes I don’t have to face another day like yesterday. Sometimes, the sky is clear, and I’ve had a solid 16 hours of sleep, and I take just the right mix of morphine and hydrocodone at just the right time, and I can almost remember what it feels like to be healthy.

And it gives me back some of my hope, and a little bit of my optimism and just a tiny bit of good the world has to offer. All the things you need to survive.

On a practical level, opioids have truly given me the ability to keep my job. Without them, I would be in too much pain to even sit up at a computer. They have also allowed me to shower twice a week, visit my best friend and her 1-year-old son, (who is super cute by the way), and even write this very column.

So are opioids dangerous, and easy to abuse? Yes. Do doctors need to be more careful about who they hand them out to? Of course.

But are they also an extremely valuable drug that literally saves people’s lives? Definitely.

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Comments (4)

  1. Gayle

    I can totally relate to your entire story, except that I suffer nerve pain as a result of a car accident, my doctor has been right on the ball with the addictive part, and my boss is now highly attuned to how much I am suffering.

    I have wanted to suicide. The only thing that stopped me was working out the finer details of not wanting my family to find me, not wanting my dogs to suffer, but how could I get someone else to me with one of my dogs being so terrified of strangers that he would surely get put down. I obviously wasn’t thinking very clearly as that went on for months. I now have all that worked out, but thankfully am not in that head space anymore thanks to my boss and my doctor confronting me and helping me deal with it.

    Since then, I have gotten drunk and overdosed deliberately several times just to get to the emergency room in the hope of some stronger pain relief and maybe a little sleep. I now know that this doesn’t work though, plus it creates issues with getting authorised prescriptions through the PBS (Australia’s drug authority) as I now have a history of overdosing.

    Currently, I am on 50mg of Oxycodone twice a day (slow release Morphine), plus 5mg Endone for breakthrough pain (immediate release Morphine), but the Endone is restricted to 20 per month. The PBS have authorised this but have now stated that it must be reduced or substantiated by three independent specialists, which will prove to be it’s own nightmare. I avoid the Endone as much as possible though as it makes me feel so nauseous and not right at all, yet barely makes any difference with the pain anyway.

    I also take a multitude of other drugs including Paracetemol, 2 types of anti-depressants, Melatonin, and even Pregabalin which is an epilepsy drug that has had good results with nerve pain. Add in a Glucosamine and a Fish Oil tablet each day as people say it helps and it can’t hurt, plus constipation drugs so my bowels don’t explode from all of these. All this to just be able to move (some days), to keep my head right (some days), and to try and get a little sleep (infrequently). It makes me feel sick just looking at my pile of 9 tablets each morning and 13 each night.

    So my life too is a daily challenge, one which is not obvious to others, and one which most people could not understand even if they tried. I would never wish my pain on anyone, but you simply cannot understand the relief I felt knowing that someone else has been through such similar struggles and emotions. So thank you for sharing your story, and you are absolutely right, it is good to write about it.

    Reply
  2. Barbara Whittington

    Wow! This article explains so well what anyone living with chronic pain has to deal with. Not only the struggled to get help with pain and to get meds but to deal with the negative connotations that go along with the suffering. I have chronic pancreatitis. Pain blocks in the nerve to my pancreas have lessened the pain currently but they don’t last. I face dangerous procedures anytime they do anything to the pancreas. WIthout pain meds some days I would stay in bed. Bless you for the well written article and prayers that you will find long term relief for your pain.

    Reply
  3. denise

    I can totally relate to you. I have been to pain management centers, 3 different ones in fact. Currently I am not attending one other than for the steriod shots in the spine. I currently take 7.5mg hydrocodone…and i can tell you it in no way shape or form comes close to giving me any relief..I think about suicide everyday and i mean everyday in every way. problem is i don’t want my child to find me.i found a friend dead last year and it sure messes with your mind, spirit and emotions. my friend was a chronic pain sufferer also..he needed many surgeries but would not get them as she had a invalid husband to care for..she was a retired nurse and strong christian beliefs that suicide is wrong….however, having said that….she knew that mixing narcotics and alchol together would equal death…she was on the fentynal patch and oxycotin and hydrocodon….she weighed about 90lbs soak and wet….and me i cant get anything…i just want out…sorry but that is true

    Reply
  4. Emily Ullrich

    Denise, I really respect you for sharing this truthful insight into pain meds. I know that when I first started taking them, I only had the short-acting ones, and hadn’t quite grasped the concept of “chronic” pain…I still thought that it was going to be different the next day. But, now, I respect what they do for me if taken appropriately, and know that I will need them every day, so I can’t take them whenever there’s more pain. After six years of being put on and off of different pain meds, and doctors trying to push Lyrica, Gabapentin, and antidepressants on me, not as adjunct therapy, but INSTEAD of pain meds, because they get kick-backs from those meds, and they don’t want to write opioids–especially in Kentucky, where I live. Because the legislation has gotten so absolutely out-of-control here, in regard to pain medicine, NO doctors (even pain docs) will write scripts. I have to travel four hours one way to another state, to see an amazingly humane, compassionate, and also knowledgeable pain doctor. I hate that I have to do this, but it’s totally worth it, just to be treated with dignity and respect, instead of being told I’m a “drug-seeker,” or like my last primary care physician told me, “If you ever expect to get the kind of pain treatment you need, you are going to have to move.” I am also a writer, but now I mostly focus on writing about pain, either in an attempt to try to raise awareness, help other patients, or advocate for better treatment. Thank you for being one of the few chronic pain writers, who actually admits she takes pain meds, and that they help!

    Reply

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