OPIOIDS, BOREDOM, AND DESPAIR

Several years ago I had the privilege of helping a nice lady, a pastor’s wife, with low back pain.  She was new and complained she strained her back moving furniture. Medicine was prescribed, including hydrocodone (opiate) for pain.

Two days after finishing the prescription for pain medicine she returned and requested a continuation of the same medication. Two days after the second prescription was finished she returned and requested another continuation of the same hydrocodone pain medicine.  At this point her exam, objectively, had improved in several aspects, suggesting that her subjective level of pain also should have been less, but giving her the benefit of the doubt a substitute non-opioid prescription-strength pain reliever was prescribed – but not the hydrocodone. On checking out, the pastor’s wife wrote a check on a closed account.

In a separate case, two separate patients, who were looking to rehab off opioids shared with me that there was a semi-retired veteran working as a doorman/bouncer for a popular Coast nightclub who every month received in the mail 100 tablets of 10 mg hydrocodone (Norco) from the V.A., presumably prescribed by his V.A. doctor for pain. He was selling them for $10 a pill at the door, reportedly selling out within two hours. If he sold them all he pocketed $1000 a month.

And then the third case, the more common one, involving deception to obtain the opiate was a man in his late twenties from Hawaii, who complained of pain from a previously diagnosed condition of trigeminal neuralgia (tic douloureux), an extremely painful condition and medical problem that often requires opiates or narcotics for relief. He'd read up on it feigning the condition as well as any top-rated Hollywood actor could have done. Fooled me on two visits but on follow-up his data information had an error that led to his deception. He was addicted to opiates.

There is no longer a stereotypical addict. Addicts and suppliers come from every demographic. The poor and the rich. The ordinary and the exceptional. The celebrity and the unknown. The street-walker and the socialite. Those married, those cohabiting, those working and the unemployed. As well as a pastor’s wife, the veteran, and the regular Joe.

The problem is complicated and defies a simple solution, as nice as that would be. There will always be people who seek to alter the mood of their lives, with chemicals if they can. As long as people get bored, or lapse into despair, or lose meaning in their life, and especially if they have or see no future, then they will forever be seeking something to assuage their misery.

I don’t have the solution but I think our culture and the lack of moral forays probably has something to do with it. Perhaps in the same way the tobacco juggernaut was felled pre-80s, with much focus and capital, I have a feeling that somehow litigation will play a role in smothering the major fire of this problem.

Jesus taught that the poor will always be with us. I think addicts will be too. The best we may be able to do is to do what we can to try to limit the number of addicts and their overdose deaths. At least giving it the attention it needs is a big start. The more attention a problem is given the more likely and quickly will the solution be found.