Police Officer Battling Chronic Pain Highlights the Failures of Health Policy, Drug War

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Police Officer Battling Chronic Pain Highlights the Failures of Health Policy, Drug War

By Kelly Burch 01/17/17

Nick Selby highlights his struggles with shame, insurance coverage and getting adequate prescriptions as a pain patient.

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Lineup of police officers.

A Texas police officer is speaking up about his experience with the opioid epidemic, both as a law enforcement officer and as a patient with chronic pain, highlighting the failures in the system that lead to addiction and illegal drug consumption. 

A year ago, officer Nick Selby awoke in blinding pain from a ruptured disc. “Since then, I’ve been stuck like a growing number of people in a system that leaves patients beholden to terrible health policy, the horrific consequences of federal drug policy, uninformed media hysteria about an opioid epidemic and an army of uncoordinated medical professionals bearing — then seizing — bottles of pills,” Selby writes in the Washington Post

After surgery, Selby was prescribed oxycodone and hydrocodone to manage the pain. Knowing firsthand the danger of opioid addiction, he weaned himself from the pills as soon as he could. However, the pain returned and Selby once again took pills for relief. 

“I asked repeatedly for alternatives, but I was told none were available,” he writes. “My first pain management doctor was terse as she prescribed more hydrocodone for daytime and oxycodone for the night, when my pain was worse. To her, I was just another person in a day of people receiving identical treatment. Later she’d say she had little choice: Insurance companies routinely deny even slightly adventurous prescriptions.”

In fact, Selby discovered that insurance would be a major barrier to alternative pain management. “My insurance company paid for eight physical therapy sessions and refused more,” he wrote. “They’ll pay for buckets of Vicodin. But non-narcotic relief? I’m on my own.”

Insurance denied Selby’s claim for buprenorphine, which he said relieved pain without making him drowsy or euphoric. Instead, they said they would pay for fentanyl, a synthetic opioid gaining popularity on the street that Selby knew was so powerful that it had to be handled with caution by police officers during drug busts.

He refused the fentanyl, knowing that he needed to have full command of his faculties in order to do his job. “As a cop, it’s even more complex: I need to be extra careful not to dull my senses, because I must be able to testify under oath that I wasn’t impaired. I must, in fact, always actually not be impaired, because I carry a gun.”

Selby also discusses the indignity and shame of being a pain patient, including having to undergo regular drug testing and presenting his pill bottles to a nurse so that the remaining pills can be counted. “Every month when I try to get my prescriptions filled, it becomes another skirmish in the War on Drugs,” he writes. 

This frustration leads many patients to turn to illegal drugs to manage their pain, Selby writes. “After four decades of all-out war on illicit drug use, scoring street heroin is still far simpler than filling a legal prescription at an authorized dispensary. How can this be considered a success?”

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