How Pain Patients Fare During The Opioid Crisis

By Paul Gaita 11/15/17

A look inside the day-to-day life of a pain patient who uses prescription opioids to be able to accomplish tasks like showering and grocery shopping.

woman holding nape of her neck in pain

As media outlets and health officials lay a considerable portion of the blame for the opioid crisis on the overprescription of painkillers, taking such medication on a daily basis remains a necessity for a number of individuals with chronic pain issues.

A life that requires pain management through prescription opioids was vividly illustrated in a piece in the Waco Tribune-Herald, which interviewed a 34-year-old man who suffers from ankylosing spondylitis (AS), a form of arthritis that primarily causes inflammation of the spine and results in severe chronic pain and in some cases, immobility.

The interviewee, who wished to remain anonymous, stated that regularly monitored use of painkillers has allowed him some quality of life.

The subject of the Tribune-Herald story, a resident of McLennan County, Texas, was diagnosed with AS in his early 20s, and his condition soon progressed to what doctors describe as an advanced case, where ankylosis, or new bone formation in the spine, leads to the spine fusing in a fixed and immobile position. In the subject's case, his spine has arched to such a degree that he must walk with a cane, staring at the ground, and cannot move his neck in any direction. 

As a result, he has been unable to hold a job, and exists on disability while living at home with his parents. The pain is so great that he is unable to indulge in one of his favorite pastimes, going to the movies, because of the discomfort produced by sitting for even short periods of time. Even basic functions, like taking a shower or going to the store, are painful, and he is dependent on painkiller medication to perform most tasks.

"I take it and it's like 'Okay, I can get up now and go take a shower, or I can take it and go to the bank and go to the store,'" he said. "I can take it and go see my friends for a bit."

The interviewee says he's aware that prescription opioids are a subject of great concern right now, but adds that people should try to remember that for some individuals, daily pain management through painkillers is their only means of achieving everyday goals. He adds that his prescriptions are monitored through a pain clinic, which requires him to regularly undergo drug testing and consult with a doctor.

However, opioids are not the only option for AS sufferers. The most commonly prescribed treatment for the condition are non-steroidal anti-inflammatory drugs (NSAIDs), which include over-the-counter medication like ibuprofen. NSAIDs have proven effective in mild-to-moderate cases, though high and continuous doses have been shown to produce serious side effects, especially stomach and intestinal issues, as well as possible increased risk of heart attack or stroke.

More severe cases of AS may require additional medications, including anti-inflammatory drugs like sulfasalazine (Azulfidine), the chemotherapy drug methotrexate (Rheumatrex) and corticosteroids like prednisone. Biologics (medications made from living organisms) like Enbrel and Humira have their advocates, as do non-prescription treatments that include relaxation techniques, yoga, acupuncture and dietary changes that avoid possible inflammatory foods, like gluten.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.