I read this article with no small amount of sadness. People going through addiction is nothing new to me or my family (is it for anybody?), and my family includes a large population of people living in this area. It also includes many people living across the country that are dependent on pain killers just to be able to go to work everyday.
Florida has become a popular destination for addicts seeking pain medication, since it is one of the few states that does not have a system in place to track the prescription of narcotics medication, helping Interstate 75 become known as the “pill pipeline” to Central Appalachia, a region plagued by prescription drug abuse.
In Bath County, Kentucky, population 12,000, overdoses on prescriptions from Florida have killed nine people since August. “We are hearing of thousands of Kentuckians going to Florida to get prescriptions, people going in droves to pharmacies in states along I-75 to get the prescriptions filled,” said Van Ingram, director of the Kentucky Office of Drug Control.
But rather than dealing with many of the very real physical reasons why so many people in this region are addicted to *PAINKILLERS* (major clue right there), it’s just easier, I guess, to go about criminalizing and cutting off access.
Isn’t it odd how the system *creates* the pain and then criminalizes access to painkillers?
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April 15th, 2009 at 6:14 am #
This is really sad. From what I’ve heard, I think this situation sucks for doctors too (the classic “when all you have is a hammer” problem). They’re kind of over a barrel, because you don’t want to create addiction, but there’s also a problem of under-treating pain–perhaps womens’ pain especially, though I’m not sure; I think men suck it up and go to the doctor later, and women go more often/sooner but don’t get taken seriously. I remember an ex-girlfriend telling me about when she was a kid how her mom spent years laid up on the couch in pain, before she was finally taken seriously and diagnosed with Lupus(!)
April 15th, 2009 at 9:47 am #
oh there is so much here. about the body, health, healthcare, addiction, stress, poverty, race and culture, the lack of access to preventative care, what we expect of ourselves in terms of health and sickness. the way that we work jobs that are highly stressful and expect us to not get sick from these jobs and expect that if we do get sick we will just suck it up. and dont provide health care. and and and
it is the slow death of our people. by a series of contradictory expectations that basically mean your body and your life subsequently are just a means to an end.
April 15th, 2009 at 10:45 am #
well, and this is also the great failure of alcoholics anonymous (and also narcotics anonymous, but i don’t know NA as well). & i say this as a person who believes in 12-step programs and has mostly very good things to say about AA.
but there is very little room to address this– to address that lots of people become addicts because they are trying to cope with an insane, oppressive world and not because there is something inherently wrong (or even necessarily different) about them. at least not in the literature, where the focus is so much on personal responsibility, self-centeredness and acceptance.
and while there are things that i think are really important & insightful & true within those discussions– it is no surprise that it was written by upper-middle class white men.
so in the end, so much depends on the community you build in those programs– who your sponsor is, who goes to the meetings you do– there is room for that analysis & understanding in the 12-step framework, but it’s hard to see it/make room for it if there aren’t other people talking about it.
and frankly, emotionally, i think it’s easier for most people to make it about themselves– i was self-centered, i was out of control, i have to change the way that think/feel/act– because acknowledging that you could live in a world that’s so hard that the only way you could figure out to cope was to use– that’s so big and out of our control, it’s more manageable to just think it’s a problem you need to solve.
okay, i’m rambling and hopefully not too off topic/derailing. it’s just that most doctors send folks with (substance) addictions to AA, because it’s the most effective model we have. and it’s not that effective. and so frustrating that these conversations aren’t happening.
April 15th, 2009 at 11:39 am #
Amapola – thanks for your comment. (Thanks for all comments, and thanks bfp for the post.)
This is an especially personal thing for me right now, the whole who-gets-treated-for-pain and how, and what the risks are and what the fuck you’re supposed to do if you’re not being helped. Me, for instance – my bottom line is that I *know* where the fuck to go get some heroin, and I will not be resigning myself to suffering just because everyone who could possibly help me either doesn’t believe me or doesn’t care. At the same time, treating my own pain would be hugely risky for me and not actually a real solution, especially, obviously, with the whole “somebody help me or I’m going to get some fucking heroin!” tantrum-y feelings.
What you said about AA though is also what sparked me to comment – I’m in AA and have been sober for a few years, and am still pretty awed by the whole thing and by the people who are in my path in that program.
But I fucking HATE that there is little to no acknowledgement, never mind engagement or criticism of, the fact that the whole thing was indeed started by white middle/upper class men, and that their privileges and prejudices are evident all over the place in the literature and in how AA practices itself to this day.
I’ve talked to other women in AA about this part too, where it’s like, the tone of recovery for so many is usually “I’m a self-centered person who is an a-hole and the way for me to be free and happy is to put others before myself.” Now, my experience with hoping to be of service in various ways is and has been pretty fucking magically positive. But it is not in line with the whole “I’ve always put me first and now it’s time to put me last!” mind set.
The thing is, I have no doubt that many men, particularly many white men, have indeed been the dominating center of their own universes for their whole lives and could stand to step back from that. But many women are completely brainwashed to do the opposite – to not feel entitled to take care of ourselves, center our needs, put ourselves before what other people want from us.
And, yeah, I have to say, there are reasons it makes sense for people to want to be out of their skulls on dope or whatever, that are not simply about “I am an addict.” I mean, me personally, the other-reasons and me being an addict are not mutually exclusive either, but what I mean is what it seems like you’re talking about – how there is so much that goes on that contributes to why someone NEEDS to put themselves out of pain. And a lot of 12 step stuff just sidesteps or ignores or re-defines/misinterprets it because it doesn’t safely fit in with “alcoholics/addicts helping each other is all alcoholics/addicts need in order to be okay and stay sober.”
Please pardon (or feel free to edit or delete!) this huge comment, I hope it’s not a derail?
April 15th, 2009 at 11:56 am #
not at all joan–this part especially is SO helpful:
And it’s what I was trying to say to begin with–I know a *whole* bunch of folks, at one point, myself included, who either are officially addicted to pain meds or who are riding that really fine line–I think I spoke here on this blog about the Mexican man on this show I was watching–he was basically addicted to asprin–and by the time he was finally able to make it to a free clinic, he had almost internally bled to death because of the asprin. Can you imagine that? They said he had lost some horrible number–like 50% of his blood volumn or something horrible like that.
but he kept popping the pills instead of getting help with his back because he *had to work*. He didn’t have time to go to the doctor. He couldn’t take time off because he was working at a resturant and how easy is it to find replacement for the busboy that keeps taking time off because he’s “sick”?
This is the kind of addiction that I am *surrounded* by. Addiction that could be helped primarily through pain relief. Or medical attention of *some* sort. Or economic help out of extreme poverty–counseling on self-centeredness isn’t going to help, nor is criminalizing addiction. you know?
April 15th, 2009 at 11:57 am #
and people are in such extreme pain–fucking hell, it’s almost a cruelty to take away one of the few things that actually help….
April 15th, 2009 at 12:27 pm #
“and people are in such extreme pain–fucking hell, it’s almost a cruelty to take away one of the few things that actually help….”
word and a motherfucking half.
April 16th, 2009 at 5:28 am #
It is cruel.
Another problem with doctors is that general practitioners are monitored for the levels of prescription pain killers they write scrips for, but ER docs aren’t, so chronic pain pretty much can’t be managed by a family doctor. It forces people to burden the ERs, or if they’re very lucky, there’s a pain clinic nearby.
April 18th, 2009 at 10:32 am #
Good post, Bfp. I had too much to say for a comment, so I have posted my response here. Thanks for getting me thinking!
–IP
April 18th, 2009 at 6:43 pm #
I’m afraid that the roots of this problem are at the federal government level, with controlled-substance schedules set by the DEA.
The sought-after painkillers in question — OxyCodone, fentanyl, morphine, methadone — are for the most part schedule 2 controlled substances. For schedule 2′s, no refillable prescriptions are allowed and an individual doctor can only give you one prescription every 30 days. For a schedule 3 drug like Vicodin or Tylenol with codeine, a doctor can prescribe up to five refills, but no more than six total fills on a prescription in a six-month period.
So that means that if the initial prescription is not sufficient for pain relief, and that they have to take way more than the prescribed dosage to relieve pain, individuals doctor have their hands tied; they can prescribe an extra medication for breakthrough pain, or up the dosage if the patient is not at the maximum yet, but they’re not allowed to prescribe three or four times the number of pills they originally recommended. They could very well lose their licenses if they do.
Hence people in severe pain often see more than one doctor and get pain pills from several sources, especially if they are in a state like Florida that doesn’t track the number of controlled-substance prescriptions an individual patient has from different sources. So instead of one doctor who knows a patient well and is allowed to prescribe whatever sie sees fit, you have multiple doctors involved in a patient’s care who have no idea how many others are involved, or how many different drugs that patient is taking simultaneously. It’s a mess.
Of course, if people are wealthy and powerful they can buy their and their doctors’ way out of any trouble either of them might get into, and can get whatever they want, whenever they want, in whatever amounts they want, with only one doctor needed to keep an eye on all of it. (Dr. Nick got into hot water over Elvis Presley’s drug abuse, which was probably one of the most extreme cases of polypharmacy in human history, but Elvis probably would have OD’d 10 years sooner if Dr. Nick hadn’t been monitoring Elvis’s intake.)