Addiction, the opioid crisis, and family pain

Laura Kiesel
Laura Kiesel, Contributor

In 2015, the opioid crisis was escalating to emergency-level proportions, claiming as many lives as car accidents. As the daughter of a longtime drug addict, the current burgeoning opioid epidemic managed to be both familiar and strange to me at the same time. My mother developed her addictions during the height of drug epidemics that occurred in New York City in the mid-1980s. The timeframe also marked the infancy of the AIDS crisis and the height of Reagan-era “Just Say No” programs. Back then, addiction was treated and viewed more as a crime than a disease, supposedly committed by scoundrels and misfits. The theory held that respectable people did not associate with addicts, much less share their homes and their blood with them.

The intense societal shaming and criminalization of her addictions led to more resistance by my mother to seek the treatment she needed, until she eventually stopped trying to quit altogether. The stigmatization of her disease impacted me profoundly as a child — almost as much as the regular abuses I endured from her due to her addictive behavior. Whether it was being the regular target of smacking, lying, spitting, stealing, or vicious name-calling, it stung all the more because society made me feel complicit by relation. I had no healthy outlet to vent my escalating outrage at my own victimization, at an age when I was too young to properly process or even fully understand what was happening. I learned to stay silent, to repress my feelings, and to isolate myself, so as not to mistakenly disclose our family secret and be swept away into the foster care system, potentially separated forever from my younger brother.

Nowadays, when I see the constant commercials and articles offering support and compassion to those suffering from opioid addiction, I am struck by ambivalence. While I feel both heartened and relieved that addiction is finally being treated as a disease for which such supports can exist, I am also embittered that it did not happen when I needed it. I am angry that the shift in dialogue around addiction — and the companion funding being offered for programs that stress rehabilitation over incarceration for those afflicted — is likely due to the demographic differences in race, class, and regional areas impacted by this epidemic as opposed to the epidemic that claimed my mother. My family was poor, undereducated, and hailed from a low-income inner-city neighborhood where most residents were not white. Thus, we were ignored.

As noted by the National Survey on Drug Use and Health, 75% of all opioid misuse starts with people using medication that wasn’t prescribed for them. Furthermore, 90% of all addictions begin either in adolescence or early adulthood, while most of those who misuse opioids already have a prior history of abusing alcohol and other drugs. In my mother’s case, she began experimenting with cocaine first before jumping to injecting heroin in her mid-twenties; there was no prescription medication involved. My uncle (who was also my godfather) died of an overdose of Xanax (which is a benzodiazepine, not an opioid) after mixing it with too much alcohol. My brother became addicted to my mother’s prescription Dilaudid (a class of opioid) while she was in the late stages of terminal cancer; this occurred in his mid-twenties, after he had struggled for more than a decade with alcoholism.

I personally decided to opt out of using opioids for long-term management of my own pain symptoms because I did not want to risk becoming addicted, considering my own substantial family history and potential genetic predisposition to the disease. However, I understand my decision is a personal one and not something I can or should expect of other people who live with chronic pain. For some patients, long-term opioid treatment can provide adequate pain relief without detracting from their quality of life, but for others it can do more harm over time.

When I hear of people with pain being shamed and stigmatized for trying to fill prescriptions for medications many of them have been using responsibly for years and even decades, it reminds me of the same shame that was thrust onto my mother and family, while we were also deprived of comprehensive and humane treatment for, and even genuine acknowledgement of, our disease. I hope the medical field will work to adopt more nuanced and individualized approaches to treating both pain and addiction that do not cater to one demographic at the expense of the other.

Comments:

  1. Jean

    Hello, I have ms. I also have had 2 major spine fusions for legitimate serious conditions. I still have daily pain from all this, surgery is not a cure-all, and I’ve been on many different meds, including opioids for the last 20 yrs. During this time I tried many, if not all alternative treatments because I truly didn’t want to live on medication! I have followed my doctors orders completely over the years and never once misused the medications, never once asked for a script early, nothing… I guess I’m one of the lucky ones who don’t fall into addiction, plus it’s in my family so I was more detirmined not to abuse. Eventually, with the guidance of pain clinics, my dosages were perfected to the point where I could function and even work part time, I had a LIFE. I socialized, I was doing well, which in turn helps with pain control.
    Now, my pain control has been suddenly and drastically reduced due to the ‘opioid epidemic.’ I’m miserable once again, I’m in real PAIN, again. I also lost my job because I don’t have adequate pain control. I’m back to being in pain, back to being lonely.
    Why should people with genuine medical conditions, genuine needs, have to suffer now because others have abused? Who decided no more? No more for everyone? Its outrageous. Its almost inhumane. What can we do? WTF is happening to this country?

    • Shannon

      I’ve only just run across this website today. I read 3 of Laura’s articles & am very impressed with how she hits the nail on the head in each of her articles that I’ve read.
      Jean, with only a few differences, your comment could have been written by me. I’ve also been suffering from chronic pain for about 20yrs. Finding a pain management regimen that helped control my pain to where I could function, and be in only moderate to low levels of pain has taken years to achieve. I’ve been through & tried countless treatments, from being over-medicated to under-medicated, PT, water PT, chiropractor, tens, trigger point injections, herbs, & on & on to not being in treatment at all. That last option had me bedridden, depressed, & on the brink of suicide. At one point I was put on oxycontin & percocette along with xanax, high doses of neurontin, & a strong muscle relaxer at night & as needed for muscle spasms occurring during the day. While that regimen had me almost completely without pain & able to work, I felt that the possibility of addiction was too high so I ended that particular treatment. For myself, I found the 10mg hydrocodone 4x daily & mild muscle relaxer at night, & Lyrica for the nerve pain that i also suffer from, adequate & acceptable. I have been at that regimen for the last 4+ yrs. Now, since all this supposed ‘opioid crisis”, my pain management Dr has cut my hydrocodone dosage in half in less than 2 mths, added another strong muscle relaxer at night, & upped my Lyrica. I’m now almost bedridden on top of now feeling “doped up” & groggy most of the time. I’m fighting feeling suicidal every single day. I don’t understand why the pain management doctors are doing this to their patients. I was under the impression that these ridiculous new “guidelines” & opioid limits were for family practice physicians and that the point of pain management physicians was to manage the pain of the patient. Not only did the Dr cut my opioid meds in half, so far (I suspect he is taking me off of it completely) but he ordered me to have another round of trigger point injections. I’d tried them 4 times previously & quit them because the results were very questionable, cost me extra money, were painful, caused me stress, & I had to find a driver for the appointment. I agreed to them again because I felt pressured into it & since being taken off the hydrocodone, that I would need even the tiniest bit of pain relief I received from the injections. I don’t know what happened but the 1st injection was so excruciatingly painful that I started crying and could not continue with the rest of them. What troubled me even more was that the Dr asked me why I was crying. I told him how painful it was & that all the other tines had been only mildly painful but this was different. He then asked me if I had fibromyalgia & if I was on lyrica!!! There I was, crying uncontrollably and wondering why or how on earth this Dr didn’t know what my meds or diagnosis was YET he was taking me off the hydrocodone!! This whole thing that chronic pain patients are going through is inhumane! Taking a medical tool that has helped patients have somewhat of a life, away from them, is not going to help those who are overdosing on heroin & fentanyl! If anything, it will cost more lives…forcing some to go to the streets trying to find some relief from their agonizing pain, and those who just can not take one more minute of the pain who will kill themselves because of it. I also would like to know what or if, there is anything we can do. I feel that doctors are purposefully causing physical as well as emotional pain to their patients! But, the patients have no recourse it seems. If we leave treatment to try to find another doctor, we will be labeled “Dr shoppers”…if we ask for our med to not be cut or taken away, we are called addicts or pill seekers.
      As far as addiction being seen as an illness & addicts being treated with kindness & empathy, well, I think the author is correct, it depends on how much money or power one has. Tragically, the stigma is still there, much like those who suffer from mental illness. The government & the doctors who are bending to pressure and taking treatment away from & abandoning their patients, should all be ashamed of themselves!! No one involved in pressuring doctors against responsibly treating their chronic pain patients who have responsibly taken their opioids for years, with those opioids, cares one bit about the people dying from overdoses….it is all about money…it always is. I should add too, dependence & addiction are two different things but if I’m addicted, its to not being in agonizing pain every single day and to being able to take care of my responsibilities. Being bedridden in agony is not living….

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