The chronic pain community has a problem.
The problem is how we talk about opioid addiction. I admit I’m guilty of it too! I’ll gladly whip out the statistics of how relatively few long-term chronic pain patients have Opioid Use Disorders. I’ll talk about the dangers of forced tapering, and the fact that restricting access to safe pain medication actually increases the rate of accidental overdoses, as pain patients are forced to seek more illicit methods of pain relief (@lifewithchronicpain has tons of resources and data about this). But there’s something I don’t talk as much about, and I should.
The thing we need to talk more about is that some of our fellow sufferers do have OUDs, but they still deserve fair and compassionate medical treatment. We get so caught up in convincing our doctors that we’re “responsible” or “legitimate” pain patients that we don’t realize the implications of our words - we’re saying that people who struggle with dependence and addiction are somehow less responsible, less legitimately in need of pain medication, even if they’re hurting just as much as we are.
And that’s not acceptable. We don’t get to rail against doctors gatekeeping our pain and then turn around and do it to others.
Am I saying we should be indiscriminately prescribing opioids to patients with OUDs? No, because just like us, each pain patient with OUDs has unique needs and goals. Some issues have more permanent solutions, like surgery, which are often more preferable for both patient and doctor alike.
But if we want to be able to say to our doctors, “I know the risks involved with opioid treatment, but I want to exercise my right to informed consent” then we need to advocate for the right for everyone to do so.
Many OUD patients don’t want to ever take anything stronger than ibuprofen because the risk of relapse. We should support that! But we should also support the people who have weighed the quality of life with monitored opioid administration, vs the quality of life with untreated chronic pain, and realized that the medication is a risk worth taking.
Opioid use disorders do not negate a patient’s rights or needs or pain. Let’s all make a conscious change and stop throwing them under the bus.