Pubdate: Tue, 17 Jan 2017
Source: Lexington Herald-Leader (KY)
Copyright: 2017 Lexington Herald-Leader
Author: Nick Selby


A year ago, I woke in the night with pain so severe I was crying before I
was fully aware what was going on. A 50-year-old cop sobbed like a child
in the dark. It was a ruptured disc and related nerve damage. Within a
couple of months, it became so severe that I could no longer walk or
stand. An MRI later, my surgeon soothingly told me it would all be OK. A
nurse practitioner handed me a prescription for painkillers -- 180
tablets, 90 each of oxycodone and hydrocodone.

I already knew how easily opioid addiction could destroy a life. I'd
arrested addicts and helped people suffering from substance abuse. So as
soon as I could, I weaned myself off the medication. Still, I fell into
the trap when my pain returned months later, and I started taking the
pills again.

Since then, I've been stuck like a growing number of people in a system
that leaves patients beholden to terrible health policy, horrific
consequences of federal drug policy, uninformed media hysteria and an
uncoordinated medical professionals bearing -- then seizing -- bottles of

I started physical therapy and sought treatment at an authorized pain
management clinic. My first pain-management doctor was terse as she
prescribed more hydrocodone for daytime and oxycodone for the night, when
my pain was worse.

A pharmacy refused to fill it, saying, "You can't mix hydrocodone and
oxycodone." When I called the pain clinic for help, the staff berated me
for bothering them. They asked whether I was seeking drugs. I was -- the
ones they had prescribed.

This shaming is common among pain patients, and there are a lot of us:
Pain affects millions of Americans, more than diabetes, heart disease and
cancer combined.

As a police officer, I've seen the opioid among people in jail and people
about to go to jail. Often, while searching cars or people, we find pill
bottles of several types of opioids -- almost always stolen or bought
illegally. Police departments are ordering the counteragent naloxone in
increasing quantities, but it can't keep up with the demand on the street.
Last month, for the first time, the U.S. government reported that deaths
from opioid overdoses surpassed gun deaths.

Meanwhile, the Center for Public Integrity reported that companies and
advocates for drugs such as OxyContin, Fentanyl and Vicodin spent more
than $880 million on lobbying and political contributions over the past
decade, compared to $4 million by groups advocating for opioid limits.

My insurer paid for eight physical-therapy sessions and refused more. Then
it declined the Buprenorphine, which had been helping without making me
drowsy or euphoric. Instead, they'd pay for Fentanyl, the stronger
synthetic opioid making cops sick just by being in the same room. It took
two months, three dispute letters and more than $700 out-of-pocket before
it finally recognize my doctor might actually know what to prescribe.

I find myself in a medical twilight zone where distrust outweighs care,
where doctors fear censure and pass me off to another office. I'm subject
to urine tests and such as bringing all my pill bottles, like a schoolboy,
so the nurse can count the remaining pills. There are specific times at
which refills will be given -- without exception.

This is almost guaranteed to lead to exquisite patient frustration, if not
addiction. It will get worse: This year, the DEA is reducing by 25 percent
the amount of almost every Schedule II opiate and opioid medication that
may be manufactured in the United States.

I had begun to consider quitting police work. Then I visited a family
medicine practitioner who started to wean me off and find the right
combination of medicine, exercise and physical therapy to keep me off
opioids for good. It's early, but this seems to be working.

How can it be that, in the name of "health," we moved away from demanding
our doctors do more than just hand out pills? Where is the exploration for
new therapies to help for pain? In Germany, doctors prescribe warm mud
packs and massage. Acupuncture is used in many countries with great
success. In 28 states and the District of Columbia, medicinal marijuana is
now legal -- but the federal government still bans it.

Almost anything is better than what we are doing now.

Nick Selby, a Texas police detective, is author of "In Context:
Understanding Police Killings of Unarmed Civilians."
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