Without Prejudice. The posts in this blog are only my opinion, and should not replace or be considered that of a qualified physician. Brand names that are commented on are not meant to disrespect of be defamatory in any sense. The posts in this blog are only based on my personal experience under a doctor monitored and regulated use of opiates as an effective treatment for chronic pain.

Tuesday, February 26, 2008

Friends with Tunnel Vision

I was at a small gathering with a healthy cross section of friends. It had become known in my circles that I was suffering back pain, and that I was undergoing several tests and scans so as to offer a diagnosis.

At the time that I began the MRI's and X-Rays and blood work, etc.. my condition had gone from something that I could cope with to a steady degenerating condition leaving me with moderate pain constantly, and if I was in any way active, severe pain.

It took almost two years to get all my scans done and to finally get in to see a neurosurgeon, who had drawn the conclusion that surgery at this point would not benefit a degenerative condition and that it would be better to consider cutting me open when when I am older. Essentially, I was too young to do such an operation, when there is a chance that the condition may either get better or worse as I age.

During these two years, my family doc would not proceed with any treatment until the final word came back from the Neurosurgeon.

Two years is a long time to wait. Especially when you are in pain.

In this position, I had two choices:
1) endure the pain, and try to manage it as best I could, including physio and a pain management program they have running at the local hospital.
2) self medicate

I guess what prompted me to begin self medicating was waking up in the mornings. Every day and night I found myself in a frustrating paradox: on one hand I was exhausted because I could not sleep comfortably. I could not lie down for any length of time, and I had began sleeping in a Lazyboy, on the couch or at my desk with my head on the keyboard. And on the other hand, if I did sleep, I would wake with such excruciating pain - what is best described as a "zipper of pain"© running down my back - that I would spend the first hour or two of each day holding my ribs and back, while I rocked back and forth crying.

A headache I could bear. And I have sprained my ankle a few times in the past. That I could suffer through as well. But everyday pain, all over the body, day in day out, in the middle of the night and the middle of the day... after a few weeks of this, I was miserable. After a few months, I had lost myself. When years had past, I was no more. I looked basically the same, but so much was taken from my heart, spirit, soul that I was all but left with a fleshy shell encasing a mass of discomfort and hurt.

So back to the party, one of my friends saw me taking a perc. and a little while later an oxy. It was known amongst my friends that I was taking them but when one young lady saw me first hand eating some pills, I was chastised!

She went off on me with a lecture from hell about all the abuse stories she heard and the experiences she had first hand watching old friends throw their lives away with this drug.

Bear in mind that while she is going on and on, she was not only drunk as fuk, but smoking joint after joint, eyes red, words slurred and emotional.

Now it is not that I don't mind listening to someones opinion and general concern for my welfare, but to add to the hypocritical fact that she was drunk and high herself, she would not listen to my reasoning behind my self medicating.

What I tried to tell her was this...
Yes, some, if not many people buy this drug illegally. And it is well abused. In my past life buying them on the street, I saw what it rendered people to. I have seen an "Oxy Den"© and saw how sick people got when they ran out.

But she was completely ignorant to the benefits of the drug in the treatment of chronic pain. And until one is able to experience chronic pain, there is no way to appreciate the lengths someone will go to, for even just a few hours of relief.

Imagine waking up in the morning with an unbearable headache. A headache that went from the top of your head, through your neck, down your back, across your ribs, and then into your hips, buttocks and legs. And imagine that the headaches is so powerful that all you can do is hold your self and cry.

Then imagine that the headache lasts past the morning, and into the afternoon. Imagine going to work with it, and then coming home. Going to bed with it and then waking up the next day with the headache still there, flucuating in waves of intensity.

Imagine how it would be for that 24 hour period - how it would affect your work for that day, your relationships, your interactions with others, your moods, your sex drive, and every aspect of your life throughout that 24 hours. You would maybe be inclined to call in sick to work. Of cancel an RSVP to a dinner party.

Then imagine that headache stays with you through a second day. Just as bad, maybe a bit worse. Imagine that no position, hot bath, massage or anything helps, and there is nothing you can do but live with it.

And at the end of the two days, imagine that you wake up at the beginning of the third day, hopeful to get back to normal only to find the headache is still there. It stay for the rest of the third day until you finally fall asleep.



take a breath.

let some time pass...


Now you wake up... and instead of your wife greeting you with a "good-morning"....
your head splits open with agony and you realize that





a very


and painful

day... again.

Week Two begins. Then the third week - every morning waking up to severe pain, spending the day with it and going to bed with it. Pain pain pain.

Then do it all again for the second month, then a third month. Then each and every day for four months, then five months. Each and everyday with no relief for six, seven, eight, nine months and all the way up to a year.

Constant pain for so long, systematically dismantles your life and turns you into a bitter, grumpy old man. Over time, it wears you thin. You spend more time trying to cope with the pain, and less time living your life. You stop being active socially and stop going to dinner with the family on Sunday. You have to leave your job, and you are unable to make love to your wife. Each day a part of your life is taken away. Each day you lose a part of who you once were until all you are and all you have is the pain.


I reached a breaking point. The doctors were not able to figure out what exactly what is the cause of my condition. Sure I had the bad discs, and the sciatica, and the spinal stenosis, but these did not add up for me, and as a diagnosis of last resort, the doctors called me fibromyalgia and gave up.

The best I got for the pain was Tramadol and some anti-inflamms. Tramadol was as good as Smarties for me, and they formed a part, of a sometimes bi-hourly cocktail that I would take. The cocktail also included T1's and Robax, Advil, industrial sized ibuprofen 600mg and a very generous helping of red wine and/or beer.

Again, back to the party, her she was, oh so pain free, telling me how Oxy will destroy my life and all I could do was laugh at her, because the one thing she did not realize is that my life was already destroyed. I was taken away from me day by day, hour by hour over the course of two years.

In a way she was simply a concerned friend. But she was not concerned about me when I was in pain. She was only concerned when I was feeling better, and the risk I was taking in order to feel better.

Her inability or unwillingness to see beyond the fact that I was taking opiates, to the reasons why I was taking them left her with tunnel vision.

Tuesday, February 19, 2008

Sex and Drugs

I want to say a lot. There is much history I want to cover on how and why I got to this point in my life. And as I start typing, I find that the topics are so intertwined that it is hard to separate and organize the coherently.

I would be lying if I said I started these pills only for pain. But ultimately pain is the reason why I continued.

Now I am looking back over this last weekend and some of the side effects to opiates.

First is my sex drive. It was not that I could not perform, it is that there was a complete absence of desire. It is as if the opiates fulfill all your needs and wants, leaving you with no desires, no needs, no wants. Or to be more specific, they satisfy all your needs and wants so that there is nothing left to satisfy.

As the opiates left my body this last weekend, and even in the depths of withdrawal, I found those desires returning. Then late Sunday night, I made love to my wife. Genuinely, I felt a desire and longing to be near her, to breather her breath, to touch her skin and taste her lips.

I miss that. I love her so much and although my sex drive was non-existent, my desire and love for her could not be replaced or taken away by any drug.

I know in the end, it is with that love that I will ultimately overcome my struggles and survive.

My doc said that the decreased sex drive could be due to stress and my work habits. Both are an integral part of my life and I do not know much else about how to spend my days other then at some form of productive activity. This usually means doing, or thinking work pretty much every waking and sleeping hour. My friends are work related, my family is work related and my wife and I work together. Work is what I am, and I usually take on too much and over-commit myself. I do not know if I would want it any other way.

Is this the cause of my diminished sex drive? Could be that I am aging and cannot multitask as well as I once could. It could also be a combination of factors. But a some things are definite.

1. I love my wife completely
2. The sex drive is affected by external influences, not a matter of the heart
3. I am not going to get any definitive answer to this anytime soon.

73 Hours Later

So our superheros made it through another weekend. It was a tough weekend, and many hours were spent with insomnia, depression, anxiety, restless legs, and our old friend chronic pain. It was surprising how long each hour was. How each time I checked the clock, only 10 minutes passed when I was sure it was 40.

But time, as it so naturally does, it passes, slow and relentless and determined.

And now, just back from the pharmacy, I have taken the prescribed amount and wait. The next 30 minutes will be spent smoking cigarettes, drinking fruit juice and waiting for the pain to go away.

The rest of the withdrawal symptoms should dissipate as well, however I suspect that the diarrhea will continue for a bit longer. Not that I mind - when I was self medicating with alcohol to numb my body from the pain (or render me unconscious at the least), I seldom enjoyed a solid shit. So whether it is the runs or constipation... it can go either way. Don't matter to me.

Looking back, after I got the apples on Saturday, I was anxious and optimistic. I wanted so much to get some comfort, and to get some sleep, that by Sunday I was out again, and as each hour passed the pain and symptoms began to rear their ugly heads.

Ideally I would have just stayed in bed, but I had work to do and had to spend the afternoon with clients looking over contracts. I kept my ground, which was probably due to the 4 percs - referred to as "regulars" - that I found. They got me through my meetings, and even got me through my evening family dinner. That is until I made the mistake of playing "airplane" with my nieces and nephews.

The kids love me so much and they are so precious to me. One of the hardest things for me to deal with is not being able to play with the kids. The youngest boy always asks if my back is better yet. I know he is hoping that I will pick him up for "airplane" and hugs, and I usually do. I pick him up without thinking about the pain that is going to come on later when I get home. And after a night of tossing them around, my back was one big muscle spasm.

Thankfully, I managed to beg a few dollars to pick up a pill to get me over the pain and get me to sleep. I held my optimism for Monday.

As Monday woke up and carried on, I went to work and saw my clients. I was in pretty rough shape, but when it comes to work I am able to turn on auto pilot and get through the performance and even managed to get a pill late in the day.

Then realty hit me with a big fat fist: due to the new Family Day holiday, the banks were closed and my paycheck did not clear, leaving me with no money for my prescription.

Beg, Borrow or Steal. By Hook or by Crook. I found an old lottery ticket for $3, a bunch of change and after counting every last dine, I managed to get enough to fill half my prescription, which brings me to now.

Now. Now I can take a moment to look back on the last few days, and ask myself some serious questions about this current treatment for my back pain.

At my age, how do I feel about potentially using opiates for the rest of my life?
How will I feel about dependency in 3, 5 or 10 or 20 years?
Have I truly explored all options, western/eastern medicine, holistic, spiritual?

I am not ready to accept opiates as my only option and with some relief, I can now afford to be introspective.

Saturday, February 16, 2008

What's Wrong?

Why am I using oxy?
I have several herniated discs due to a genetic condition in my spine, along with fybromyalgia and an undiagnosed inflammatory condition that causes pain in my back, ribs, hips, and wrists. These are aggravated by 12 years of repetitive strain from computer work, bad exercise habits and posture.

I have an inflammation in my neck that gives me amazing headaches and I have pain attacks that come without warning and can render me almost unconscious.

Basically I hurt a heck of a lot, most of the time.

Scarry Doctors

It is harder than you think, finding a doctor to prescribe these pills. Because of all the bad news we hear, and how strict they are regulated, combined with the addiction and tolerance that comes with it, it is increasingly harder to get a prescription.

The use and abuse of oxy by people looking for a high or to profit, ruins it for those who genuinely need it.

It was only when I had hit bottom self medicating with Alcohol and vast quantities of Tylenol 1's, did a doctor finally start me on a prescription. It was apparent that I was causing more damage to myself, mentally and physically, trying to cope with the pain on my own. And had I continued on this route, I would have either destroyed my liver and kidneys, declared bankruptcy, or lost my mind, or all of the above.

It is important to understand that medications such as Tylenol and Advil (without prejudice), effective as they are, are not meant for long term high dosage. They are designed to get rid of a headache, or ease a sprained ankle. Using them for more than a couple of weeks, and in my case, handfuls for over a year, can begin to impact your body in negative ways.

But doctors face closer scrutiny when it comes to opiates. They must keep details records, sign contracts with their patients on how the opiates are used and the lifestyle the patient leads. The patient must pass drug screens to make sure they are not taking other drugs. And a good doctor will require that a patient consults with him/her if for any increase, even if it is just one pill on one occasion.

Under close monitoring and regulation by a good qualified physician, opiates can have little to no side effects aside from dependence and tolerance. When all other options have been explored, opiates can help those who suffer from chronic pain lead a normal and healthy lifestyle, where they would otherwise be confined to isolation and poverty due to the lack if mobility.

But look at the left and see the news articles. They are all about the bad stuff that happens when opiates are abused and left to inexperienced individuals.

There are pros that can outweigh the cons of opiate use. And we must weight then accordingly and make sound judgments based on education and experience.

And Then I Saw Green

Just when we thought it was over for our superheros, they managed to find some cash.

How great it would be if cash would instantly turn into oxy, but finding the money is only the first in a long series of steps to pain relief in the black market.

I remember watching a movie called Candy, which was about a boyfriend and girlfriend hooked on heroine, or some type type. At a early point in the movie, the narrator says something like "for every 7 years as a junkie, 6 years are spent waiting," and how true how true how true that is.

I made the calls to my sources, and being 10:30 am, only one was awake. I was told to be there in ten minutes. The ten turned into twenty, then an hour and as usual, just as I was about to give up and go home, the delivery arrived.

After waiting for so many hours, the last ten minutes, driving home with my oxy 80 (referred to as "apples" on the street), seemed to be the longest ten minutes of my life.

And just in time too. No sooner did I take in half the Apple, did the stomach cramps begin with a vengeance, as I ran to the bathroom to flush out every ounce of substance from my bowels.

Cramps and the runs seem to be the most common symptom of withdrawal, and it took about 20 hours after my last pill to start. THis is the longest I ahve gone without a pill in 17 months.

Other symptoms I experienced through the night is insomnia and what is knows as restless leg syndrom.

If I could have slept the night away, it would ahve been easier. If I had something that would knock me out - Valium, Cough and Cold DM, or even some sleepeaze - then the night would have been bearable. But the insomnia forced me to stay awake throught the night while my restless legs made sure that I was quite uncomfortable - tossing, turning and kicking - all night long.

Restless legs, jimmy legs, kicking legs are not necessarily painful, but are very uncomfortable. It starts as a sensation in the lower back that makes you feel like you want to stretch your back and legs all the time. This sensation and desire to stretch makes your legs twitch and kick around.

This is the first symptom an the only way to get relief is to sleep it off, eat Tylenol 1's and apply heat. I had no Tylenol, so I ate my Robax and the maximum allowable anti-inflamm's. I put the heating pad on max, and snuggled up to my pillow, stretching, tensing,relaxing my legs and back until I fell into a light nap. How I would have loved some Valium, and I must remember to hide some for days like these.

I managed to doze off for a hour here and there until 10:30 am.

So with Saturday properly medicated, I now have 58 hours until I can refill my prescription.

Friday, February 15, 2008

This hurts.

Almost 18 hours since my last pill, and by now whatever was in my system is fast breaking down. As the meds dissipate from my body, it is becoming evident how bad in shape my body really is.

The pain starts in my ribs, and in my neck. Tight muscles that have been in spasm for the better part of a decade, and hard tissues that are so inflamed that it hurts to move. Heck, it hurts to lie down, or to sit. There is no comfortable position and I know that I will fall asleep in the next hour or so.

But I hate the mornings most. So much hurt! The kind of hurt that makes you want to lie down, but lying down is what causes the hurt. So all I can do is stand there, holding my sides and rocking back and forth trying to find a position that provides even a few minutes of relief.

This hurts. And it is going to get worse.
73 hours to go.

Out of Meds

I ran out of meds today. This is the first time since September 2006 that I have been without any oxy.

I have 74 hours until I can refill my perscription, I have no money or anything to pawn and there is no one who will lend me some pills to get through the next three days.

This is going to be a long night. I have no idea what my body is going to do while in withdrawl, and I am honestly quite scarred. I have read the blogs and forums and I know what the typical symptoms are. And I am not so much worried about those as I am the depression that has already gotten a strangle hold of me.

I realize now that one of the other benefits oxy is that it numbs you to a lot of emotion and feelings.

How long has it been since I had a sex drive? How long sicne I had any genuine appetite for anything?

If I could find a pill, I wouldn't have to think about it. But since I can't, my mind has started reasoning and the word that best describes how I feel is "cheated". Cheated because I have to trade off so much just not to be in pain.

So the long night begins... 74 hours to go.

The Toothache and The Bear.

I don't know why I started. There were three main reasons. The first and foremost was a degeneration of my discs and several herniations. For a long time I was albe to tolerate the pain, but with each day that passed, I felt it wearing me thin, and I began to realize that I was no longer the once happy, ambitious young man I once was.

It is like the story of the bear with a toothache, or a lion with a torn in his paw. Miserable, tempermental and downright nasty the animal was changed the moment the pain was gone. And I felt the same when I took the first pill.

The pain was gone, and I slowly began to return to the person I once was.

Bad Rep O

If you take a look on the left, you'll see a number of articles form Google News. Chances are that a few of them are about the sale and/or tabuse of opiates.

A friend of mine who has three ruptured discs said to me that he felt opiates, especially Oxycontin has received such negative press that a stigma is now attached to it and anyone that uses it.

Like most things newsworthy, the public does not want to hear about nice and happy things. They like staraing at accidents as they drive by hoping to see a body in a stretcher; they want to see guns and missles in the east; they want to hear about the actor that overdosed. Sure we like the good will story once in a while, but not at the frequency that we like to hear about the bad.

So it is not surprising that we hear very little about how oxycontin has helped thousands, maybe tens of thousands (hundreds of thousands?) of people who suffer from chronic pain, return to and once again enjoy a quality of life.

It is important to balance a socially conscious awareness of the abuse opiates with the benefits of a doctor monitored and regulated treamenet program.

Avoidance of Adverse Stimuli

A couple of years ago I was reading through a Psychology textbook and came across a section on behavior and conditioning.

The chapter looked at studies involving mice and different motivators used in observing how they responded under different situations. Food was used in some, sex in others, but the most interesting experiment is where they placed a mother on one side of an electrically charged plate, and her baby mice on the other side.

The electric plate was used as a source of adverse stimuli, and food, sex, water, etc was used as the motivators. When food, or sex (a male on one side and female on the other) was used, the mouse would not cross the plate to obtain its reward. However, when it was the mother - separated from the baby mice - she was willing not only to cross the plate, suffering electrocution, but would do so at increasingly stronger voltages, up to a point the charge could have killed her!

The mother was willing to suffer great pain, and even death to reach, secure and protect her children.

This study ranked motivators, and placed the parent/child at the top, food, sex, water, etc at the bottom and second form the top, avoidance of adverse stimuli (the electric plate).

When it came to pain, the mother was willing to face the adverse stimuli for her children, but without baby mice on the other side of the plate, neither sex, or food, or water, or any other motivator could get the mouse to cross the plate.

Nothing could get the mouse to endure pain.

I give us humans a bit more credit then mice, however, barring any metal disorder, at the basic psychological and behavioral core, pain is a really really difficult thing to deal with.