Painkillers

I've been meaning to write about this topic for a while. My experience with them over the past year has given me a perspective that I've really wanted to share. I was reminded this morning by some pain around one of my ribs on the left side of my chest, likely a tumor pushing on something as I'd mentioned yesterday.

When I was at my worst last year, I had to deal with pain. Right before my pleurodesis, as I was in pre-op, I felt a sharp pain in both sides of my chest. It wasn't fully correlated with my tumors; while I had a lot of them in me, mainly on the left side of my chest, I think some of it was the stress of the moment. I called for the nurse, and she gave me an IV push of dilaudid. Almost immediately, I felt a warm feeling starting from the center of my chest pushing outward and pushing all the pain out of my body. I also felt sedated and calm. It creeped me out a bit -- did I just get high?

I have to say, though, that dilaudid was very helpful in getting through those days. First, the ones in the hospital for pleurodesis, and then right before I started chemo again, thanks to pain from a spine tumor that oxycodone barely made a dent in. Yes, I've gotten quite familiar with the opioid family of medicines. With most chemo regimens, aspirin and ibuprofen aren't allowed because of their blood-thinning effects. So if Tylenol doesn't work, the only choice left is to go with a narcotic.

I'm glad my pain went away quickly after I started chemo, minimizing my need for painkillers. Once I experienced the effects of the dilaudid push, I felt that I saw in a way that I hadn't seen before the tempting nature and addictive potential of these drugs. Looking back on that experience, where I was able to get a very strong painkiller (here's an interesting chart showing the relative strengths of different opioid medicines -- dilaudid is four times as strong as heroin, which is actually a legally available prescription drug in some countries) on demand, I remembered how downright miserable I felt. My tumors were causing me pain, fatigue, lack of appetite, coughing, and on-and-off fevers, and I was only getting sicker. The narcotic high was about the only thing that could wipe that all away, at least temporarily. So even with all the negative connotations around the term "getting high," it is in fact medically necessary to do so sometimes. I was fortunate to recover from that condition so that it was no longer necessary, but for many other cancer patients with advanced disease, it is a way to ease their last moments of life.

For all the good that these medicines have done, though, they also are major contributors to the societal problem of drug addiction. Sometimes it is a result of having to take opioid medicines for a long time due to severe chronic pain. But in other cases, otherwise healthy individuals are using them for the "feel good" effects. I wanted these medicines when I was feeling utterly miserable. The question in my mind is, what is the source of sadness, unhappiness, emptiness, or frustration in the lives of otherwise healthy people that makes them feel like they need to turn to drugs that are this powerful for an escape? Based on this, I feel that the mental health aspects associated with this, or any other illness for that matter, should never be neglected.