Thursday, August 7, 2014

Addicts and Chronic Pain Sufferers, An Unfamiliar Similarity

So, before you rip my head my reading the title of this post, hear me out. I know this will probably be somewhat controversial but I have been thinking about this idea a lot, especially in the past year and before any addicts or people with chronic pain start sending me hate mail, just listen (err, read):

Around October last year, I went to go visit one of my good guy friends mostly because his older sister was in town and I really wanted to see her. We hadn't talked since I had moved home and had been diagnosed so she was, like most people, unaware of what was really happening to me because I had been pretty vague about my situation. Background: this girl, we'll call her "Morgan", is an addict in recovery and sober for several years now. Most of her story took place before mine even happened to me, but now she's doing great (and actually getting married this month!).

Like my situation with her, I did not know all the knitty, gritty details of her story either and what ended up happening that day was a major eye opener for me. What started out as a very generic "So what's been going on with you?" conversation very quickly turned into some really deep shit. (It's amazing when you have pain, who you end up confiding in and being close too.) I thought Morgan and I would resonate on the we've-both-had-hard-times level, but it turned into a lot more than that. We shared sentiments about feeling like we've been financial and emotional burdens to our families, relationships ruined indadvertedly because of what had happened to us and the general scariness of the future. Before either of us knew it (or expected), we were both bawling in her family's living room, hugging each other.

Now, I've known a decent amount of addicts generally as acquaintances but never really on a deep a level like I had with Morgan that day in October. Before I left Morgan's house, she had said something to me along the lines of "Wow, we really are going through the same thing! I can't believe we have so much in common going through all of this."  Initially, I remember coming home and being in shock. At first, that statement started to annoy me. I thought "Even though alcoholism and being an addict isn't really her fault, it's more of a choice than what happened to me." I didn't want to have and feel the same emotional conflicts as an addict and it didn't feel fair to me.

But then I had an epiphany and something really important came to mind: even though people with chronic pain have shitty stigmas attached to their disease, addicts have even shittier stigmas and while there are some real ignorant assholes out there who truly believe addiction is completely a choice, for the most part, it really isn't (to me and a lot of other people anyway). I've taken some real interested in addicts over the last two years (to the point of considering going back to school to be an addiction psychologist) and have done a lot of reading, talking to addicts, watching a shit ton of documentaries and picking apart my grandpa's brain (former CEO of a psych hospital in Maryland and psychiatrist) about the psychology behind being an addict. I truly believe that if you have a genetic predisposition to addiction, happen to try alcohol (who hasn't), or worse, drugs, and at the same time happen to be clinically depressed, anxious, generally have a lot of unfortunate shit going on, etc. there's a decent chance it could happen to you. I think a lot of these people are just trying to treat themselves in their own way. Now I'm not saying, if you try a glass of wine and happen to be depressed, you're going to turn into a raging alcoholic, but I really do think there is that chance with anybody. (Also, if I'm wrong about this, please email me! I would love to know more.) But just from knowing several addicts, this is my personal experience.

I also realized simultaneously, that I had been playing the victim card a lot. "This happened to me." I thought it was not at all my fault and took no accountability or responsibility for my actions. The truth is, I was not being good to myself. Like addicts with a predisposition to addiction, I had a predisposition to hypermobility. (I was probably born with it and have had it all my life but it never really bothered me until a year and a half ago.) The last few months of my job were easily becoming more stressful and I felt like it was starting to suck the life out of me. I was increasingly becoming more depressed, not working out, eating like crap and was in-between therapists. I would wake up at the ass crack of dawn, go to work, come home from work, take a nap, order GrubHub (usually Chinese or some sort of comfort food), shower and fall asleep around 8 or 9 PM. I was slowly alienating myself from my friends and just struggling to get my daily chores/errands done because all I wanted to do was sleep and lay in bed (oh, the irony). I always wonder if I had forced myself to work out more throughout the week, eaten better and had seen a therapist, if this all would've even happened to me and, if it did, would it just have been delayed more because I had been taking better care of myself. Of course I also recognize that most people could get away with this "lifestyle" I had taken on, but I always wonder if, because of the hypermobility and stress, that is the reason I ended up where I am. For the record: no doctors (not even Dr. Gerwin) can officially say how this happened to me, but my hypothesis is his best guess as well.

The most interesting aspect to me of the similarities between addiction and chronic pain is that both are lifelong things you deal with. Whether I finally turn a corner with all of my pain or my friend Morgan stays sober the rest of her life, it is always something both of us will be forced to be conscious of. She will probably go to AA meetings the rest of her life and never try to put in herself in a situation that's not good for her. I, whether I want to or not, if I have any chance of coming out of all this pain free, will be forced to continually exercise, eat well and get therapy. Even if I'm perfectly "normal" 20 years from now, myofascial pain, hypothyroidism and hypermobility are things I will always have, even if the pain "goes away", it will always be there.

The more I started thinking about all of this, the more I incidentally found things like this:

(You can click on it to view a larger image.)
The funny thing was, when I had started this blog, bored and frustrated on a Saturday night, and had relayed the message to people with chronic pain and addicts, the willingness to participate varied. 99% of all people I knew that had chronic pain/invisible illness were willing to share their stories…and not even necessarily anonymously. Most addicts were a very soft maybe and anyone I know that had chronic pain and subsequently, an addiction to pain pills from having chronic pain, pretty much shut me down entirely (even though they respected what I am doing).

Before I had "entered" the world of chronic pain, shit like this never even occurred to me. Occasionally when I would hear about people with addiction due to chronic pain, it would make sense to me and I would feel sympathetic on a very topical level, but once you start to experience it yourself, you start to look at things a little differently. Fortunately (or unfortunately) for me, like I've said before, I'm pretty much allergic to all pain killers and am probably the least likely person that would ever have a real addiction to anything (baked goods and puppies don't count), but on a much smaller scale, a few months ago, this actually happened to me. Maybe the only drug that helped me over the course of my experience with chronic pain was Ativan, a drug in the benzodiazepin class that also includes drugs like Xanax, Valium and Klonopin. (Ativan is a little bit stronger and I was taking a pretty high dose of it.) This drug was nice because it cleared my mind, sedated me a little (little things do) and took the edge of my pain.

Unfortunately, it could not take all of my pain away, but it definitely helped and I was at least taking it morning and night (sometimes mid-day depending on how bad my pain was, if I had just gotten injections, etc.). It didn't give me side effects and it felt like sunshine in pill form. I had been taking it for a few months until one day, it just completely stopped working or having any effect on me. Tried it again the next day and still…nothing, so I went off it and had horrible withdrawal effects for almost 2 weeks. These withdrawal effects included insomnia, anxiousness/irritability/restlessness, sweating, heart palpitations, headaches and dizziness. There were so many times where all of the withdrawal effects would be happening and I would look over at the Ativan bottle, knowing that it didn't even help me anymore, and consider taking one just to make all the side effects go away. This kind of hopelessness takes you to a new level desperation.

Luckily, Hollywood slowly seems to be spreading awareness for people who have addiction because of chronic pain. Ironically, right before my little addiction happened, August: Osage County came out. (If you haven't seen this movie, I strongly recommend it.) Very long plot shortened: Meryl Streep has cancer of the mouth and subsequently is a pain pill addict. At the beginning of the movie, her husband commits suicide and the family comes in for the funeral. Everyone in this family, especially Julia Roberts (the eldest daughter), simultaneously try to deal with their grief of their father/brother/uncle and Meryl Streep's addiction. Obviously I couldn't find the exact scene I wanted but this movie is filled with lots of tension. In the below scene, Meryl Streep had just rubbed her addiction in her daughter's face after a very awkward and nerve-wracking post funeral lunch.

Plus, there's always Dr. House to count on. In the show House, a common side plot deals with his chronic (leg?) pain and his consequential addiction to Vicodin. That show periodically gets pretty intense.

Luckily, it seems like this issue is gaining awareness. Just a few days ago, a friend who graduated from UPenn sent me a study Penn researchers are doing with chronic pain and addiction. For anyone reading this, whether you'd like to post your story or just send it to me, I'd love to read it if you feel comfortable sharing it. 

This what a somewhat depressing post. Here's a picture of my puppy, Sophie, at 8 weeks old that will fill your heart with pure joy. 

PS. I apologize for the long time between posts, I got caught up in baking for two days straight for a friend and I promise there is much more to come! xx

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