Opiate medication is not "fun" when you really need it

I’m quite thankful to report that I really, really like my neurologist, who does indeed have a lot of experience treating migraine (even though I don’t believe I’ve seen her name pop up on any official specialist lists).  Dr. M. is personable, friendly, and very serious when she needs to be. I know her schedule is insanely busy, but she stays with me as I look through my list of questions and make sure we both understand one another. She’s also very willing to work with me on treatment plans, especially when I tell her I want to do as many lifestyle changes, supplements, and vitamins as prophylactic treatment before taking daily prescription meds the way I used to.  I know she may not always agree with me, but she respects my opinion and knows when and when not to push. Anywho—all this is to introduce a topic that came up with us this past year.

A few appointments ago, she was clearly concerned about how my migraines had gotten more frequent.  She added an extra dose of B2 and magnesium to my daily regimen and confirmed that I didn’t want to do any daily prescriptive medications (she was right—my mind hadn’t changed). I did tell her I was concerned about not having any rescue meds in my arsenal, and she wrote a prescription for Tylenol 3. I’m to take it when I am out of triptans and the migraine hasn’t been kept at bay.  It doesn’t make the migraine disappear, of course, but it makes the pain fuzzy around the edges and usually helps me relax and sleep, which helps the attack drift away.

Once I ran into an acquaintance upon leaving the pharmacy.  I was a little tired after a long day and I didn’t think to gently say, “I’m sorry, but I’d rather not tell you what meds I’m on” (or perhaps “It’s none of your business whatsoever!”) when the person asked, “What’re you picking up?” “Oh, some Tylenol 3 for my bad migraine days.” “Oh, badass! That stuff’s supposed to be awesome,” said the acquaintance, who then went into the pharmacy to get whatever he was there for.

I remember getting a similar response from friends when I was prescribed Lortab many years ago when I got a severe corneal abrasion (one of those metal closet hooks to the eye—it was as awful as it sounds).  It was one of my first times getting an opiate prescription for the treatment of pain, and I laughed the comment off—I knew these drugs had a reputation.

As I’ve gotten older, though, and seen that many people who can benefit from treatment with painkillers are not getting the drugs that can help due to misplaced public policy concerns, I have gotten less tolerant of these offhand comments.

Because you know what?  Taking opiates or other serious painkillers isn’t fun when you need them, and you don’t look forward to the times you have to take them. When the majority of chronic pain patients hold such a prescription, it’s because they sometimes—if not most of the time—reach a point where they cannot physically or emotionally handle the pain.  When your eye has been poked by a metal hook, Lortab can dull the pain and allow you to sleep, but it never goes away completely. And in no way can the slight fuzziness and disconnection from your healthy self be confused with an addictive high.

Yes, drug addiction is a major problem in the U.S. and around the world. Yes, large numbers of people abuse opiates. But if you know someone with pain who has been prescribed these medications, please refrain from making silly comments about how “fun” it is going to be for them to feel the effects of their pills.  I can assure you that every patient I know would forego all medication, no matter the effects, if he or she could live a pain-free life.

Have any of you felt judged for having a particular prescription? Have you had trouble getting prescriptions you need? Have friends joked about how your medications will get you high?  Please share your stories below. 

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