In the last five posts, we have been discussing the opioid crisis. An epidemic that has taken thousands of lives and devastated thousands of families. Interdiction has not worked very well at all. Physicians limiting the prescriptions that they write for opioids and using other strategies for dealing with pain may have an impact on the epidemic. But what are we doing about the demand for these drugs?
We, unfortunately, seem to be a society that believes that pain should be eliminated as quickly as possible. That any unpleasant feeling should be erased. In the last 40 years, we have been doing more of this with prescription drugs — painkillers, antidepressants, and anti-anxiety medication. Prior to their development, we made extensive use of alcohol and still do. Codeine was a popular additive to many medicines sold over the counter in the 19th century. Today marijuana has become quite popular both as a recreational drug and one that can be useful in treating pain and nausea. All of this is trained as a society to expect that we can take something that will eliminate our discomfort. If we are to reduce the demand for opioids perhaps we as a society need to find other ways of managing our discomfort and use these medications and others only when there is no other alternative.
The last challenge we’re going to present in this series focuses on the limitations that we face in providing effective treatments for the addiction.
You stand in line each morning, like cattle, waiting to get into the methadone clinic. You have been coming here for about a year and it feels just as shameful now as it did when you started. You were prescribed opioids to treat your chronic pain for many years. When the laws were changed restricting access to them, you turned to heroin. And now here you stand.
Put yourself in the position of this person. Share this challenge with others and think about how you would use the skills and attitudes of resilience to deal with this challenge. Describe in some detail how you would do this.
As with the other challenges that we have presented in the series, they are from a serious game called Bounce Back that we have been using for some time as a training tool in public education.
Here are some of the skills and attitudes that we think would be helpful in dealing with this challenge.
Connecting with others is important. To do this you may have to push against your feelings of shame and deal with other strong feelings that you have. Confronting this alone is very very difficult. Connecting with others is necessary. You are not alone. Many of the people involved with methadone feel the same way. The problems you are facing are the problems they are facing.
There is strength in numbers. Get involved with the support group. Talk with the therapist or counselor at the methadone clinic. If they can’t or won’t help find someone else outside of the clinic who will. If you have Medicaid or insurance you may be able to talk to a therapist other than the one provided by the clinic.
Take care of yourself. You were not always addicted. This is a disease you’re dealing with. Don’t blame yourself. Try to see the bigger picture. There may be other options you haven’t explored. Get some help in looking for those.
Dr. Ron Breazeale