Migraines and the stigma of chronic pain medication use

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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