by Diana Lee
A recent episode of the A&E show Intervention about a woman with occasional migraines and other serious health problems who takes up to 50 Percocet pills a day made me uncomfortable. Maybe Danielle, the woman featured in the episode, really does have migraine attacks. But she is also an addict. One condition really has nothing to do with the other. Many people with acute or chronic pain use pain medication without any accompanying addictive behavior, not that you would know it to watch this kind of show.
Danielle’s abuse of pain medication under the vague assertion she has migraines is frustrating because it increases the likelihood all migraineurs and chronic pain patients are viewed through a lens of skepticism about their pain. As someone with chronic, debilitating migraines, it is hard not to take this personally. Migraines, like many other chronic conditions, are invisible. You may notice me sweating profusely, wearing sunglasses indoors, pressing on my brow bone, having trouble finding a name or word or holding my breath to avoid taking in smells that would not bother most people and not realize that I am having a migraine attack.
In fact, these behaviors might lead people who aren’t familiar with the symptoms of migraines to believe I have a drug abuse problem or some other secret to hide, all the more so if they happen to see me popping the pills I use to treat my attacks.
Intervention does a wonderful job shining light on the issues surrounding addiction, the process of getting a loved one into treatment and the difficulty of staying sober. But it is not able to differentiate between physical dependence on pain medication and addiction to pain medication and tends to create the impression that people who use pain medication are mere steps away from full-blown addiction. The failure to delineate this distinction reinforces common misconceptions held by the general public about pain medication use.
Chronic pain patients, including migraineurs, deal with this on a day-to-day basis with family and friends who don’t understand the role of pain medication in their treatment plans.
The behavior of people like Danielle lead to all migraineurs being viewed with skepticism when they end up at an emergency department seeking treatment for an excruciating, intractable migraine. People with legitimate pain arising out of a neurological condition are too often forced to fight to be treated at all, let alone with any modicum of respect or dignity. I fully acknowledge emergency departments are not the best option for treatment of an intractable migraine attack.
However, many circumstances arise in the lives of migraineurs that occasionally necessitate treatment in this setting. Addicts who hop from doctor to doctor and ED to ED claiming excruciating migraine pain and begging for or demanding narcotics cast doubt on anyone who shows up at an ED requesting treatment for a migraine attack.
I find myself wondering if people who don’t know about my situation think I’m doing what Danielle seems to be doing in using a legitimate medical condition as an excuse to abuse pain medication. I use prescription pain killers, but I do not use more than I am prescribed nor do I mix medications I have been told not to take together. I never use anyone else’s pills and I follow the proper channels for obtaining my medication. Above all else I am very careful to follow the instructions I am given by my doctors and pharmacists.
It may not be fair, but I resent people who don’t do the same and hope I’m not labeled as being in the same category.
Diana Lee is a writer and attorney who lives with chronic migraines, occipital neuralgia and depression. She blogs about these issues at Somebody Heal Me: The Musings of a Chronic Migraineur.
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{ 8 comments }
The vast majority of patients whom I see in the ER with complaints of a severe migraine and requests for pain medication are either malingers or drug-seekers with track records of shopping other ER’s for pain medication. It’s also quite common to see compliant patients suddenly slip into addition given a new stressor in their life, be it a new job, a new child, or another responsibility.
No matter how much you may resent having the label of an addict as a patient with chronic migraines, I can tell you with utmost surety that you will have that label in every ER you go to in the country. The onus will always be on you to prove yourself as a known quantity and, indeed, an exception to the classic drug-seeking, malingering, chronic pain patient.
Fifty Percocets daily for migraine? The drug, or withdrawal from same, is probably causing the migraine.
Heck, I’m surprised she still has a liver.
I don’t think you are alone in feeling uncomfortable over the story of a woman with “occasional migraines and other serious health problems who takes up to 50 Percocet pills a day.” That doesn’t sound normal to me!
I watched a show about interventions more than 20 years ago. Some years later when a family member had a serious substance abuse problem I was reminded of the show and how there had been a way to get the woman help.
It was instrumental in helping me to accept that my loved one had a problem that wasn’t going to go away and to seek help for him.
I don’t know what the deal with chronic pain is because I haven’t ever had it. What I do know is that getting the word out about intervention programs can be a lifeline to everyone involved.
Although the show may have given people the wrong impression about people who suffer from chronic pain I think their overall message is worthwhile so I have to support their choice of topic.
It isn’t the disease that causes the label – it is the behavior. If we see someone at 3 AM for their 14th episode of abdominal pain (14 negative CT scans, 3 normal MRAs, one normal angiogram and two non-diagnostic laparatomies in the last year…) who ran out of drugs after their pain clinic was raided by the DEA, then we will assume they want drugs, attention or both.
Most ERs have no problem treating pain but we hesistant to feed addiction. We also see pain so frequently (and drug seekers even more frequently) that we’re pretty good about noticing what it looks like vs someone who is lying for secondary gain.
On the other hand, prescribing narcotic pain drugs is fairly common and routine for stuff like wisdom tooth extractions for which pain drugs should not normally be needed. Perhaps if such unnecessary drug prescriptions were not done, fewer people would become addicted, and the supply of “leftovers” that get sold to addicts will not be as large.
50 Percocets daily is certainly excessive. On the other hand, anon 7:48, under treatment of pain is a significant problem, too. Your attitude is why so many patients with legitimate pain issues are frustrated and angry and may be moved toward two unhelpful extremes: giving up and ignoring the pain or getting inappropriately creative in drug-seeking.
There was a research report not too long ago in which 6 weeks of under treated chronic pain was associated with structural changes in the pain reception areas of the brain and in the peripheral nerves as well.
It’s all about correctly diagnosing the patient’s problem, crafting a balanced, comprehensive treatment, and proper follow-up (of course, you don’t get paid to take a lot of time to do that!).
Also reports where death from OD on prescription opiates is up over fifteenfold in the last ten years.
Friend: I also suffer this disease and really painful, but based on appropriate medicines’m doing to get ahead, this medication oxycontin is good for pain but it causes anxiety and is dangerous if you can not control it, findrxonline visit a few months ago and in his article on oxycontin show that can be dangerous if not prescribed by a doctor and if one does not adequately control the sensations they produce, I really hope to have more news from you.
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