URL: http://www.mapinc.org/drugnews/v17/n036/a08.html
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Votes: 0
Pubdate: Tue, 17 Jan 2017
Source: Lexington Herald-Leader (KY)
Copyright: 2017 Lexington Herald-Leader
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Details: http://www.mapinc.org/media/240
Author: Nick Selby
I’VE SEEN OPIOID CRISIS AS A COP. LIVING IT AS A PATIENT IS WORSE
A year ago, I woke in the night with pain so severe I was crying before I was fully aware what was going on. A 50-year-old cop sobbed like a child in the dark. It was a ruptured disc and related nerve damage. Within a couple of months, it became so severe that I could no longer walk or stand. An MRI later, my surgeon soothingly told me it would all be OK. A nurse practitioner handed me a prescription for painkillers — 180 tablets, 90 each of oxycodone and hydrocodone.
I already knew how easily opioid addiction could destroy a life. I’d arrested addicts and helped people suffering from substance abuse. So as soon as I could, I weaned myself off the medication. Still, I fell into the trap when my pain returned months later, and I started taking the pills again.
Since then, I’ve been stuck like a growing number of people in a system that leaves patients beholden to terrible health policy, horrific consequences of federal drug policy, uninformed media hysteria and an uncoordinated medical professionals bearing — then seizing — bottles of pills.
I started physical therapy and sought treatment at an authorized pain management clinic. My first pain-management doctor was terse as she prescribed more hydrocodone for daytime and oxycodone for the night, when my pain was worse.
A pharmacy refused to fill it, saying, “You can’t mix hydrocodone and oxycodone.” When I called the pain clinic for help, the staff berated me for bothering them. They asked whether I was seeking drugs. I was — the ones they had prescribed.
This shaming is common among pain patients, and there are a lot of us: Pain affects millions of Americans, more than diabetes, heart disease and cancer combined.
As a police officer, I’ve seen the opioid among people in jail and people about to go to jail. Often, while searching cars or people, we find pill bottles of several types of opioids — almost always stolen or bought illegally. Police departments are ordering the counteragent naloxone in increasing quantities, but it can’t keep up with the demand on the street. Last month, for the first time, the U.S. government reported that deaths from opioid overdoses surpassed gun deaths.
Meanwhile, the Center for Public Integrity reported that companies and advocates for drugs such as OxyContin, Fentanyl and Vicodin spent more than $880 million on lobbying and political contributions over the past decade, compared to $4 million by groups advocating for opioid limits.
My insurer paid for eight physical-therapy sessions and refused more. Then it declined the Buprenorphine, which had been helping without making me drowsy or euphoric. Instead, they’d pay for Fentanyl, the stronger synthetic opioid making cops sick just by being in the same room. It took two months, three dispute letters and more than $700 out-of-pocket before it finally recognize my doctor might actually know what to prescribe.
I find myself in a medical twilight zone where distrust outweighs care, where doctors fear censure and pass me off to another office. I’m subject to urine tests and such as bringing all my pill bottles, like a schoolboy, so the nurse can count the remaining pills. There are specific times at which refills will be given — without exception.
This is almost guaranteed to lead to exquisite patient frustration, if not addiction. It will get worse: This year, the DEA is reducing by 25 percent the amount of almost every Schedule II opiate and opioid medication that may be manufactured in the United States.
I had begun to consider quitting police work. Then I visited a family medicine practitioner who started to wean me off and find the right combination of medicine, exercise and physical therapy to keep me off opioids for good. It’s early, but this seems to be working.
How can it be that, in the name of “health,” we moved away from demanding our doctors do more than just hand out pills? Where is the exploration for new therapies to help for pain? In Germany, doctors prescribe warm mud packs and massage. Acupuncture is used in many countries with great success. In 28 states and the District of Columbia, medicinal marijuana is now legal — but the federal government still bans it.
Almost anything is better than what we are doing now.
Nick Selby, a Texas police detective, is author of “In Context: Understanding Police Killings of Unarmed Civilians.”
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