Chronic Pain and Counseling.

• Author: Ruterbaugh, Dolores T.
• Position: PARKING THOUGHTS

THE U.S. HAS BEEN, for years, in a crisis of opioid misuse and abuse. This is no news flash, of course, but perhaps a little reminder about how so many of these people who are addicted to opioids became addicts is in order. It all started innocently enough, with physicians seeking to provide comfort to patients in pain. Minimal dental work could get you a prescription for NSAID and codeine; heavy pain medication, self-administered, was standard.

Medications, in general, were easy to acquire, and quickly offered: the high-strung college freshman, anguished over upcoming finals, could be given a prescription for powerful, addictive benzodiazepines without even asking. Those grieving were offered antidepressants, as if their brain chemistry and not their life, was suddenly and devastatingly turned upside down. Pain medications and psychotropic drugs were prescribed for longer and longer periods of time, altering brain chemistry, creating addictions, and leading to an inability in some people to tolerate normal ranges of emotional and physical experience. In short, a lot of people who became addicts were innocent victims of well-intended interventions.

Intolerance of the normal ranges of emotional and physical experience also led otherwise healthy people to experiment with mind-altering drugs, to abuse pain medications--to steal them, buy them illegally, or present themselves in emergency rooms where prudent medical staff screened them carefully as possible "drug seekers."

Life hurts. Maturation hurts. These are truths, and not terribly pleasant. Normal living creatures avoid pain; flinching is, after all, a reflex--the message need not even reach the brain for the withdrawal from pain to occur. So, people find ways to numb emotional pain: alcohol used to excess; sex; gambling; shopping; pornography; overeating; overwork; overexercising; and a variety of brain-numbing, distracting behaviors such as video games and TV binge-watching.

When those things do not work, or fail to work quickly enough, pain medication--opioids--often steps into the breach. We have seen this before, circa the late 19th century here and in Europe, when opium became a regrettably popular way to check out of life. Now, we have people stealing drugs from dying family members, chewing on used pain patches to extract whatever powerful Fentanyl remains (yes, it's gross, and yes, it actually happens). Then people die, and the obituaries are littered with astonishingly young...