My first experience taking prescribed/needed pain medications in recovery.

  1. The prejudice that exists against recovering addicts in the medical setting. I am a nurse, I am a recovering addict and I had real pain that was not treated.

    My first experience taking prescribed/needed pain medications in recovery.

    In the last eleven years I have had several experiences with lack of treatment for legitimate pain associated with documented, confirmed diagnosis of disease or condition. The first six years of this time frame I was in a contract agreement with Addictionologists who prescribed Subutex or Methadone, I was obligated to disclose this. While I choose not to include this as a part of my true 'recovery' period, I was honest.

    My first experience was with cancer. I had been diagnosed with Hodgkin's Lymphoma at age 38 and I was taking Subutex. A bone marrow biopsy was ordered and obtained without analgesia. Perhaps no one receives analgesia, I really don't know. I only know that it was very painful. I screamed for the entire procedure, I believe it lasted about 20-30 minutes.

    The second experience was a stirrup fracture, or Lisfranc fracture of the left foot. I tripped over the tongue of a trailer and bent my foot in half. The three middle metatarsals were broken clean in half, I was in a boot for six months.

    The third experience was a kidney stone. After disclosing my maintenance opiate status, I was at least given Toradol after four hours of writhing in agony. This was enough for me to relax and pass the stone. And I was grateful.

    We are now in the period of what I refer to as my 'true' period of recovery. I have been off all mind and mood altering drugs for two years. I have a bad tooth, I need an implant but I'm scared. I know that I must be honest about my recovery and past addiction. I will feel pain and maybe the pain will be bad. I don't treat the tooth, I let it rot. It rots for the next three years, untreated. At least there's a tooth there, instead of a gap. And let's get real, drug addicts often have gaps. Who wants a nurse with bad teeth?

    Last year, in 2017, I got Shingles for Christmas. It was a fairly bad case, with lesions on the left side of my chest. They also ran along the left shoulder, up the left back side of my neck, into my hairline and behind the left ear. It was the strangest, most painful experience to date. Most painful, because the worst of it lasted unabated, for four days. The nights were always the worst. I was given Gabapentin, the first dose worked. The doses after the first dose did not work. I fought my urge to jump up off the couch and run down to the nearest ER to beg for relief. I'd disclosed my recovery status to them before, did I really want to go through the humiliation again? It was going on day five, with no relief and I fell asleep praying. I woke up in better shape, I was able to bear it from that point on.

    I have a support system in place and I'm working my tail off for recovery. And this tooth in my head is still rotting. Obsessively brushing my teeth because I am afraid my breath smells because of it; I never smile. It's important to mention here that I have dental insurance, good dental insurance. It is not lack of finances preventing me from treating this tooth. It is fear. Fear of pain, fear of judgment, fear of a medical professional deciding I don't get relief of pain, because I am a recovering addict.

    The inevitable begins to happen, it starts with just a slight twinge of pain. Teeth are shifting a little because the roots of this cosmetically very important tooth are weakening and I'm forced to do what I have been dreading. I bring it to my group and tell them my fears ( based on very real life experience ) and together we begin to formulate a plan. The first priority is that I am NOT going to suffer anymore. I go for my appointments leading up to the procedure, literally shaking. I fill out my history forms honestly, as I always do. My spouse comes with me as a support and we make the appointment. The day of the appointment arrives and I grip the chair, I am discharged with antibiotics, a rinse and a tiny, little prescription for Norco 5mg/325mg, 12 tabs and NO refills.

    At this point, I have now been in recovery for over five years. There is some trepidation involved in getting up the courage to take that first dose, as there should be. I wait until the numbness completely wears off, to be sure I'm feeling pain. I've had an extraction, I've had drilling, I've had bone grafting, I've had some digging and what felt like chipping and shoving around of existing bone. But I'm an addict, I'm not allowed to feel pain ( or if I do I'm gonna need to suffer through it to prove that I'm really in recovery ). It's real, I feel pain. I take the first dose and totally anticlimactically, I fall asleep. Wait, I haven't robbed the CVS? Or spun out of the driveway, in search of a new drug dealer? I can't believe it.

    I never deviated from doctor's orders, I took these pills as prescribed. My five years in recovery were a beacon of a better life and one I did not wish to leave behind, just because I had legitimate pain. It is important to note that not everyone who is abstinent desires recovery. I do not discount the chances of an addict who is merely abstinent to go right back to the drug, they are not usually honest about anything. What I propose is the medical profession learn to recognize the differences. Those in contracts with Addictionologists should at least be given a conference call, with all parties present, 'hey doc, my foot is missing.' When a person in recovery discloses to you their status, it's so that you can remember it when deciding to approve refills. It's not so that you can decide if they require no treatment at ALL. We're human, we experience pain. A legitimate prescription is not the difference between recovery and relapse, it is simply humane. Apply strict prescribing practices, that's good medicine. It's protection for everybody.

    I'm now twenty-four hours the other side of my last dose of Norco. I feel no symptoms of withdrawal, I feel no cravings for more. I didn't have to sacrifice honesty, or integrity. My wits are not addled, I can read directions and abide by them. What I do feel is relief... I'll get my pretty, new tooth in about three months and I can smile again. We do recover!
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    About Persephone Paige, RN

    Stephanie McCauley, RN St. Augustine, Fl. Still searching for a new niche

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    5 Comments

  3. by   Kitiger
    Are you afraid the doctor will refuse to give you the needed narcotics for fear of a relapse? Or is it that you will need higher doses to get the pain relief that you need, and you're afraid that the doctor will not give you enough? Both?

    I had one occurrence where the doctor decided that I was drug-seeking when I was only trying to get some answers, to find out what was causing the pain. He was prepared to just send me on my way! And I wasn't even looking for pain meds.

    I do my best to always be honest, and it shocked me to find a doctor who just decided on his own that I was lying!

    Is that how it is for you?
  4. by   catsmeow1972
    The vibe that I am also getting is that she is afraid of taking anything for fear of "waking" the addiction. My experience with addiction has merely been from observation but I have come across people that believe that one cannot be in recovery if one is taking pain meds. So by that perversion of the philosophy a person with many years sobriety would be starting over after needing major dental work. That's makes no sense whatsoever.
    In addition to all of the issues you state, I think there is the fear of needing the very thing that triggered this to begin with. I've had (frequently elderly) patients refuse pain meds because they "didn't want to get addicted," not understanding that when used appropriately, it is not addiction.
    By the end, I hear relief that not only was the pain treated correctly, she was able to take the appropriate amount and be done, over, not wake the 'monster' and still look forward to a delightful life in recovery.
  5. by   rn1965
    Quote from catsmeow1972
    The vibe that I am also getting is that she is afraid of taking anything for fear of "waking" the addiction. My experience with addiction has merely been from observation but I have come across people that believe that one cannot be in recovery if one is taking pain meds. So by that perversion of the philosophy a person with many years sobriety would be starting over after needing major dental work. That's makes no sense whatsoever.
    In addition to all of the issues you state, I think there is the fear of needing the very thing that triggered this to begin with. I've had (frequently elderly) patients refuse pain meds because they "didn't want to get addicted," not understanding that when used appropriately, it is not addiction.
    By the end, I hear relief that not only was the pain treated correctly, she was able to take the appropriate amount and be done, over, not wake the 'monster' and still look forward to a delightful life in recovery.
    Cats,

    I have been in recovery for over 13 (closing in on 14) years. I can tell you that those folks do not represent the majority.

    My last sponsor has MS and takes Vicodin. She takes it as prescribed and does not abuse. I, myself, had an emergency hernia repair and MAJOR dental work (bone grafts, wisdom teeth extracted, & gum surgery). Not only did I opt for oral sedation (dental), but, I took pain killers after both procedures. I spoke with my doctors and my sponsor.

    Yes, I was terrified the doctors may not treat my pain and it was a bit embarrassing to tell them, but, I was lucky, and neither treated me as a "junkie". They both were grateful I told them and they prescribed Vicodin both times. The hernia surgeon prescribed so many that I tossed the remaining Rx once I had zero pain for 72 hours (pain I could treat with ibuprofen).

    As for needing to start over in recovery, or not being "sober" when I am taking prescribed meds, I've never run into one person who thought that way. Or, at least they did not express it to me.

    I have been a sponsor and have been sponsored, and I would never tell someone that. It is a shame but, even in recovery, we do have those zealots who think this way. Luckily, they are few and far between.

    Recovery is long journey and we must always keep in the front of our minds the possibilities of relapse. My DOC is booze and lots of it. It has been many years since I have even thought of a drink. But, I do not kid myself, one sip and I am dancing naked on a table again! Nobody wants to see that!

    RN1965
  6. by   Persephone Paige
    Thanks to all who responded. My fears were that I would need pain relief and not get it. I can't help the things that naturally occur, like Shingles. But I have avoided self care ( needed dental work ) for fear of rocking the boat. Is is smart? No! Will it ultimately result in more problems further on down the road? Yep! It's avoidance. There's always the hope that I can hold on through my IPN contact without needing narcotics. And within the IPN community there are the strict hard liners, some of them have control of your life, that are completely against pain relief unless you've been in a tragic MVA. It's hard to stand up against that. The pain will eventually go away (we hope), but the judgment lasts. These aren't the case managers, they were very supportive. These are often the facilitators. I don't see my case manager, I do see my facilitator on a weekly basis. Do I want to face that weekly? I don't, I've got enough stuff on my plate. I personally can't find a job. IPN has been of no benefit to me other than advocating for a conditional license that I cannot put to use. Add the stresses of being an IPN particpant to recovery, joblessness, the existing stigma of addiction and self care ( that may or may not require pain relief ); something has got to give. For me, I sacrificed self-care to avoid the judgment. I'm not doing it anymore!
    My recovery was hard won. I value it above all else. There must be a protocol, other than just individual prejudices, to assist recovering addicts to safely treat real pain. I think my dentist did an incredible job. My history and recovery status had always been listed on every history I had filled out for him. I had never asked for pain meds and I'd been going to him for about four years prior to this procedure. He prescribed a small but reasonable mg, with a maxium of 3 days treatment. I stretched the doses out over five days, taking on tablet every eight hours, with Ibuprophen in between. It was more than adequate. My tolerance had reset itself a long time ago and it knocked me out.

    I will say that I reiterated the fact that I was in recovery, face to face. Let's face it, doctors see a lot of patients. At the same time, I also told him that I was no longer willing to suffer real pain, untreated. And he HELPED me... I gave him the information he needed to make an educated decision about how to prescribe for me, he used that to keep my doses minimal, but effective. He listened to me, I listened to him. WOW!

    Anyway, I hope my account has helped someone. Opiates were my DOC, during the time I've been clean/sober I've done a tremendous amount of work on myself. Recovery is about more than just putting down the drug... This experience has solidified that for me. While I am always wary of an Opiate, I was able to discover that the work I had done assisted me in following doctor's orders. And my God, the relief I feel! I took the very last Augmentin last night. It's really behind me now. All I have to do now is to wait for the bones to nit together and I'll have a better smile.
  7. by   Persephone Paige
    I wanted to add that my current IPN facilitator was very supportive too. My previous facilitator would have been dead set against using pain medications. I still loved her, but she had very strict views.

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