In August 1994, I walked into the office on a Saturday afternoon, intending to spend a few hours finalizing a brief due in federal court the following Monday. At that time, I was a civil rights attorney with the justice department. Just 30 minutes into my work, I was struck by an excruciating pain in my back, which felt like acid burning through my spine. In quick succession, my muscles seized, and I fell to the floor, overwhelmed by the intensity of the pain.
I had no idea then that this agony would linger for nearly two decades, rendering me unable to sit, stand, or walk without assistance. I couldn’t have predicted that I would eventually rely on opioids for pain relief.
The ongoing conversation around opioids today largely focuses on the devastating toll of overdose and abuse. However, there’s another side rarely discussed: opioids are among the most effective medications for managing severe pain. For me, they were a means of reclaiming my life.
Through appropriate pain management, including opioid treatment, I transitioned from being bedridden and unable to sleep for months to a functioning individual who negotiated significant settlements and argued cases in federal court. I may not have been able to sit or stand, negotiating via video calls and managing my work from a makeshift platform bed, but I was still able to maintain my career and contribute to society.
Unfortunately, many pain patients today are not as fortunate. In our efforts to combat the opioid overdose crisis, legitimate pain management is being compromised. Long-term patients who depend on opioid medications are often unable to fill their prescriptions due to state-imposed dosage limits, typically ranging from three to seven days. Even in states where exceptions exist for chronic pain, insurance companies frequently deny coverage based on these regulations. As a result, many patients are forced to taper off their medications involuntarily, even those who have never exhibited signs of misuse. This can lead to increased pain, loss of mobility, or even suicide.
Recently, a comment from Attorney General Tom Wells to pain patients—“Sometimes you just need two aspirin and go to bed”—demonstrated a profound lack of understanding of chronic pain, which can severely impact quality of life, comparable to that of late-stage cancer. Approximately 50 million Americans suffer from severe or persistent pain, which is 25 times the number of those who misuse opioids. Chronic pain is the leading cause of disability in the U.S. and costs the economy more than half a trillion dollars annually.
It’s crucial to differentiate between using medication to restore health and misusing substances that lead to dysfunction. The majority of individuals who use opioids for pain management do not abuse them; studies indicate that the risk of addiction among these patients ranges from only 0.07% to 8%. Moreover, when opioids are prescribed appropriately, with proper screening and follow-up care, the risk of addiction significantly decreases.
Most people who misuse prescription opioids never received them through legitimate medical channels; they often acquire them from family members, friends, or illicit sources.
Like many patients, I hesitated to use opioids initially, trying every other treatment option available first. My pain stemmed from a surgical procedure that resulted in nerve damage. I explored infusions, nerve blocks, repeat surgeries, and alternative treatments like acupuncture and biofeedback, but nothing alleviated my suffering.
Ultimately, the use of opioids in conjunction with integrative care enabled me to sustain my professional life and find a sense of community until I was able to heal. My experience is one of many that often go unheard—one where I was able to use opioids for years and safely discontinue them when my pain subsided. Given the current climate around opioids, such narratives may soon become rare.
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Summary
The opioid crisis often overlooks the reality of chronic pain patients who depend on opioids for relief. While the focus is on combating misuse and overdose, legitimate pain management is being compromised. Many patients face barriers in accessing their medications, leading to increased suffering and disability. Personal experiences highlight the importance of understanding the distinction between proper medication use and substance misuse.