Twenty years ago a woman we’ll call Estelle* came to my office for coaching. Estelle was 84 and had been living with chronic pain from two failed back surgeries she’d had years earlier. She’d been on opioid pain medication since before the first operation.
As with my other pain clients, I was struck by the consistency of the suffering despite the meds. Her story put me in mind of a client with chronic headaches who had been on eight Vicodin (hyrocodone) a day–two every four hours. Also, no relief from the drugs.
Estelle’s life was, literally, a mess. Her apartment was so cluttered that she’d been ashamed to have visitors. She couldn’t sort the mail. Instead, she plopped it on whatever surface she could still find–all of it, junk flyers, letters, and bills jumbled together. No place to sit, she spent most of her days in bed. She saw no friends and went out only to doctor appointments.
Estelle was an addict. Recent press coverage has alerted us to the severe and growing problem of pain-killer addictions, greater in number than that of any other substance, whether legal or illegal. I drew the following statistics from the Aug. 22, 2014, Wall Street Journal.
The Center for Disease Control and Prevention informs us that over 16,500 people died from opioid-based pain medications in 2010. The number of prescriptions for hydrocodone-based drugs dispensed last year? 128.86 million. Sales increased 21% from 2012 to $1.05 billion, although the number of prescriptions decreased 6% over that time period.
My husband returned from the pharmacy with 2 bottles prescribed by the dentist for his upcoming surgery: 1) antibiotic 2) hydrocodone. The latter joins the company of unused bottles in our closet prescribed by various medical professionals–some for back pain, others for who-knows what. None of the prescribers has ever asked him if he has a history of addiction, or even checks his electronic medical records (if these in fact actually work) to find out how many times he’s filled the prescriptions in the past. No controls via the pharmacy’s computer, either.
He’s never been counseled to discard old bottles, to avoid “sharing” the pills with others, nor to guard the drugs from illegal use by others in the household–spouses, children, health care aids, cleaning help, babysitters, houseguests. None of his prescribing professionals has ever discussed the side effects and risks from taking hydrocodone.
Despite this total black-out of information, when the dentist completed the implant, he handed my husband a pill and a cup of water. What did that pill turn out to be? You guessed it–hydrocodone.
So, what does this have to do with Estelle? Estelle joined Narcotics Anonymous, worked hard, and got off her pain meds.
What happened to her pain? We worked together to identify triggers, to rate the pain’s intensity, and to conquer the fear of pain, which had driven her to dose so frequently with addictive medications. Paradoxically, pain meds can produce a rebound effect, in which the drug cycle actually increases the pain. Employing the beneficial techniques of hypnotherapy, biofeedback, breathing, and guided imagery, I was able to help her improve on all pain measures.
Once Estelle was both drug-free and comfortable, she joined the local community center’s writing circle, surprised to discover that she had talent. She added a choral group and exercise classes and was trying to fit in a card game. The mail? Oh yes, she’d thrown all that junk out.
I hope she is never handed a pain pill by a doctor or dentist. Such an ignorant mistake could set her back years.
I don’t know if the day an 84 year old woman walked into her first NA meeting it surprised anyone in the group. Recent awareness of pain medication addiction and its lethal consequences has made it clear that this frightening problem knows no age, religious, or socio-economic distinctions.
If any of this sounds familiar to you, take a lesson from Estelle. Observe Pain Awareness Month: attend your first NA meeting tonight.
*Like all examples in this blog, “Estelle” is a teaching example, a composite of several stories plus narrative flourishes.
LINKS OF INTEREST
- Prescription painkillers: 5 surprising facts: Why you should be concerned about opioids—the most prescribed drugs in America
- The New York Times’ 2013 piece “The Problem With Pain Pills“
