Treating pain after opioid addiction: A personal story

Peter Grinspoon, MD
Peter Grinspoon, MD, Contributing Editor

Follow me on Twitter @Peter_Grinspoon

As a primary care physician at Massachusetts General Hospital (MGH), I am profoundly grateful for my 10 years in recovery from opiate addiction. As detailed in my memoir Free Refills, I fell into an all too common trap for physicians, succumbing to stress and ready access to medications, and became utterly and completely addicted to the painkillers Percocet and Vicodin. After an unspeakably stressful visit in my office by the State Police and the DEA, three felony charges, being fingerprinted, two years of probation, 90 days in rehab, and losing my medical license for three years, I finally clawed my way back into the land of the living. I was also able to return, humbled, to a life of caring for patients.

There is one question that I invariably get asked, by my doctors, colleagues, friends, family members, and at lectures and book talks: now that you are in recovery from opiates, what are you going to do when you are in a situation such as an accident or surgery, when you might need to take opiates again? I have blithely answered this question with platitudes about how strong my recovery is these days, and how I will thoughtfully cross that bridge when I come to it. In other words, I punted consideration of this difficult issue into some unknown future time.

Unfortunately, that future is now, and that bridge is awaiting my passage.

Last week I slipped on my top outside step, which was covered in ice, went into free fall, and managed to completely tear my left quadriceps tendon. This required a surgical repair in which doctors drilled three holes into my kneecap and then tethered what was left of my quadriceps muscle to the kneecap. Taking Tylenol or Motrin for this kind of pain is kind of like going after Godzilla with a Nerf gun. I was sent home with a prescription for one of my previous drugs of choice: oxycodone.

My leg was hurting beyond belief. I literally felt as if it were burning off. But, I had spent the last 13 years of my life conditioning myself, almost in a Clockwork Orange kind of way, to be aversive to taking any and all opiates.

What is a person who used to suffer from a substance use disorder (SUD) to do? There are millions of us in this country who may eventually face this choice.

Fortunately, I am not the first person who has confronted this issue. There exist safeguards one can put in place. It is important that all of your doctors know about your history of SUD. It is also helpful if you have a significant other or partner at home who can manage the pills for you, and dole out two of them every four to six hours as directed, to avoid the temptation to take more than prescribed in order to get high. (Old habits die hard.) Finally, the key to all addiction treatment is being open and honest. It is critical to check in with one’s support network about medications, cravings, and fears, and to use all of the recovery tools that are available to you, such as asking for help if you need to, and not trying to control things that can’t be controlled.

In the end, my level of pain was so great that there really wasn’t any choice but to take the oxy. My nerve receptors made the decision for me. I’m sure there are Shaolin monks somewhere who can block out high levels of pain, but that just isn’t me.

I am reassured, and even pleasantly surprised, by several aspects of having taken the oxycodone. First, it worked well for the pain. Second, I did not get high from the pills. I guess that taking two pills is different from taking (or snorting) 10 or 20, as we tend to do when we are addicted. Finally, it was very easy to stop taking them, and I have had absolutely no cravings or dreams about using since stopping.

This is a critical issue. It would be cruel and inhumane to not sufficiently treat any patient’s pain, especially after surgery, and it is important not to discriminate against people with SUDs. There are millions of people in recovery from opiates in the United States alone, and they are as deserving of pain control as anyone else.

Finally, I am grateful beyond belief to have survived my opiate addiction, and to not have become one of those all too common overdose stories we all read about in the newspapers. I am also grateful to my excellent doctors at MGH for fixing my wounded knee, and for providing me adequate pain control. Fortunately, my recovery and my pain control do not seem to have been mutually exclusive.

Comments:

  1. Elizabeth WMcGlone

    I’m really glad to read this story . You were able to use these medications for their intended purpose. The key points for me were also telling my surgeon about my use history. My family is suffering this problem. My mom has a surgery and she has unbearable pain. When I read story and I suggest my mom to take this process. Now a day, she is free from that pain.

  2. Elizabeth WMcGlone

    I’m really glad to read this story . You were able to use these medications for their intended purpose. The key points for me were also telling my surgeon about my use history. My family is suffering this problem. My mom has a surgery and she has unbearable pain. When I read story and I suggest my mom to take this process. Now a day, she is free from that pain.

  3. Evelyn Zak

    I’m happy to read this and that you were able to use these medications for their intended purpose. I had a similar scenario, slipping on ice and pilon fracturing tib/fib. It hurt a lot and I had extensive surgery. The key points for me were also telling my surgeon about my use history, telling recovering friends, keeping the mess in safe hands, and using as prescribed. Then one day I didn’t have intense pain anymore and OTC mess we’re enough. No cravings, no euphoric recall, nothing. Today makes the 31st year of my decision to stop abusing all mood altering substances!

    Thanks for posting!

  4. Elizabeth Deleo

    I’m so happy for you! I love hearing stories such as these I have a close family member struggling with this . Tears your whole family apart. But in the other end of it, my husband has pancreatic cancer . We are at mass general waltham . He is stable for now has horrible neuropathy and arthritis worse after chemo and they make him jump through hoops for a tramadol prescription . He has never been pull seeking. So he simply doesn’t go back to get refills and suffers in pain because everyone is so worried about addiction . Again , pancreatic cancer. 5 yrs 7% survival.

    • Lori Geiger

      Terribly inhumane!!! Look into hospice care..they treat their pts. with compassion, care and dignity!! Best of luck to you, I lost a dear friend years ago to pancreatic cancer. Such a horrific disease. My heart goes out to you, your husband and family.

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  6. Karen Ortwein

    I have been on Opana ER for about 13 years. I take exactly as directed–1 every 12 hours. I have Percocet for breakthrough pain up to 3 in a 24 hour period. As a rule I take 2 per 24 hour period. I’ve never craved either drug. Why such self control? Well it’s not really a heroic feat on my part, I think it’s just my physical constitution. I don’t like not being in control–it terrifies me. I didn’t smoke, drink or take drugs in my teens. Even as a young person I didn’t want to be out of control and vulnerable. So I’m very thankful for that. I deal with pain from lupus, vasculitis, rheumatoid arthritis, migraine, cervical stenosis/spondylolithesis and other painful problems. I owe much to having a personal relationship with Jesus Christ and as a result I can take my constant pain/torment to the Lord in prayer. The relief and calmness I receive gets me through the day. I wish I wasn’t in this pain and I hope access to opiates isn’t removed in the future. I need them as do many others. We can hope science will bring a solution.

  7. Peter Grinspoon, MD
  8. Malena S

    Its happy to hear that you recovered from opioid addiction. The addiction to opioids such as heroin, morphine, and pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. Even I got addicted to drugs in my college days and I wasted two important years of my life. It took me six months to recover from these habits and I know it was painful. Now I work in a reputated company and provide services to master and phd students for their research.

  9. john

    i would like to say this blog helps me in my battle and to know that he as a doctor experianced what patience do..i mean that with no harshness…i have digenerative disc disease and siatica…i been on pain meds for the last seven years to this point in my life…i went on my own and have gotten help ….im current on subs but i find my self in your situation …im looking in to get spinal chord stimulator…..i been thanking and nerves are
    shot until i found this blog….your human compation should be spread to doctors every were…..after surgery and pain is gone i will get back on sub and have confedence that i will retain my abstinance….thank you for this blog really} it works if you work it!!!