What If No One Can See Your Pain?

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From time to time, when yet another celebrity dies tragically from an overdose of painkillers, people ask me if I think prescription painkillers should be banned.  The answer is no, and today I’ll tell you why.

It’s a sad fact that we have lost too much talent far too young, from Prince to Philip Seymour Hoffman, Whitney Houston to Heath Ledger. And needless to say, tens of thousands of regular people, our friends and neighbors and family members, have lost their lives to prescription drug overdoses as well.

Here’s the thing: people in pain should not have to suffer because others abuse their medicine. It’s important we not lay 100% of the blame for these deaths on the medicine itself. The intention of these medications is not to cause death, it’s to offer temporary relief to the millions of users who take them as directed. Tranquilizers can ease grief and anxiety. Analgesics relieve pain and offer quality of life. It is the misuse and abuse of analgesics and tranquilizers, especially when combined with alcohol or other drugs, that can result in death, not the medicine itself. If someone cuts their wrists, do you blame the knife?

Many people become outraged at the drug manufacturers, and jump to the conclusion that banning these drugs is the answer… but you can’t understand the other side of this story unless you’ve been there yourself.  Imagine this scenario:
You have a serious medical condition that affects your nervous system like multiple sclerosis, or severe lower back pain from a car accident. It’s a pain that others can’t see, like a broken leg in a cast or a bruise or laceration. You can only tolerate the pain if you take hydrocodone every day. You go into the pharmacy to get your refill, but since you’ve lost your job because of your disabilities, you’re not dressed as well as the other customers. Pharmacist Jones is skeptical of you, thinking you might be an addict, and she doesn’t like you showing up in her pharmacy every 30 days like clockwork for your 60 pills. She fears you will bring your friends, and word will get out that she dispenses narcotics to pretty much anyone. Then one day you’re turned away because your doctor prescribed 180 tablets instead of 60. The physician only prescribed that amount because he knows that you can no longer afford to see him monthly, so he prescribed enough to hold you over for three months (this practice is not uncommon). Maybe you live out of town, so he prescribes a lot. Regardless, the pharmacist perceives 180 tablets as excessive and tells you she’s out of stock. In pain and shame, you or your spouse or caretaker must drive to several other pharmacies until a compassionate pharmacist fills your prescription. Is this fair?

Pharmacists are naturally cautious about what they dispense, and with good reason.  Oftentimes they kick their caution up a notch following a celebrity overdose.  But when people die from drug overdoses, there are usually many causes, not solely the prescription drug itself.  Restricting medicine at the pharmacy level will never stop the problem of overdose and moreover, chronic pain sufferers should never have to pay the price for substance abusers.

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