Dear Editor,

Last week, the inimitable Derek Ridgely wrote a mostly thoughtful explication of the current situation regarding the opioid epidemic in his “Extrospectives” column. Where his argument fell flat was in this paragraph:

“Ironically, while opioids are demonstrably effective for treating acute pain, their effectiveness in treating chronic pain has always been vigorously debated. Because most individuals build up a tolerance over time, the addiction risks inherent to long term usage often outweigh the benefits.”

That’s it – all he had to say about the millions of Americans who experience chronic pain and, precisely because of the for-profit medical establishment we have, plus the essential puritanism of the American establishment, have found themselves the unwitting and completely innocent victims of this particular War on Drugs.

I have rheumatoid arthritis. That means that, despite the amazing advances in biologic pharmaceuticals that keep me mobile, I am in fairly constant pain. Most days, it’s manageable – a background level of, say, a 3/10. But occasionally I have a “flare” that bounces the pain level up to where it wakes me from a sound sleep.

When I was diagnosed, in 2008, I was able to keep a supply of my opioid of choice in my medicine cabinet for those occasions. Last year, after a move, I was looked at like a potential druggie and forced to sign a contract with my doctor that I would never go to another doc for one of these drugs. And my scrip was only for a very limited time.

I hear horror stories from others with chronic diseases – of being kept on such a short leash with these drugs that they would run out mid-flare, with a doc nearly impossible to reach for an emergency prescription.

And it’s not just a problem for those of us who know we’re going to be hurting. In 2000, I had an attack of shingles. For ten days, the only thing that kept me sane was that bottle of Vicodin in the medicine cabinet that kept me unconscious enough to avoid screaming with pain. This summer a friend came down with shingles, and she was offered FOUR DAYS’ WORTH of opioids. Period. No more for her. Her pain didn’t matter to the terrified and cowed medical establishment.

Some of this overreaction comes from actual legislation – one more example of our legislators pretending they are physicians (but let’s not get into that right now) – but mostly it’s from the medical profession self-censoring in order to avoid lawsuits. Once more throwing the ill under the bus.

One-solution-fits-all rarely works well, except for the bureaucrats who don’t want to be bothered dealing with messy exemptions. As with so much these days, the individual doesn’t account for much.

Lynn Hirshman

Peak to Peak