I Take Opioids, So I’m Obviously A Drug Dealer (Call Me)

It’s time to talk about pain. Ugh, yeah, I said it. That four-letter word that we all despise that can make everything so much more, well, everything. Even though it may not seem like it, cancer can be very painful, and pain medicine is an integral part of the diagnosis from beginning to end, and beyond. Unfortunately, it’s not always easy to get what you need and to get it to where you need it to go.

The pain is real

Let me just start by saying, holy cow! I had no idea how painful cancer was! I know, it sounds ridiculous — like going to buy an electric car and finding out it runs on electricity. It really caught me by surprise, though. I have anaplastic large cell lymphoma, and the tumor is located on the right side of my lower abdomen. You don’t generally think of that part of your body as particularly sensitive. You never hear someone say “he kicked me right in the family... side of my abdomen.” Or maybe you do, and you live in a really weird town, but you get the idea. It’s not a place that is normally considered to be especially tender.

Now, I’m no stranger to pain medicine. Or pain. Or medicine. Whatever, point is, I have been dealing with opioids and the strings attached since I was sixteen years old. The so-called “opioid crisis,” is a new thing, but it’s not like pain meds were ever easy to obtain. I remember even twenty years ago handing my local pharmacist a script for a high dose of Darvocet, an early cousin of Percocet, and having him say “I need a letter from your doctor saying it’s ok for you to take this much.” I looked at my mom, who was immediately on the same page, and we both said, we just gave you a prescription, which, funnily enough, is a letter, from his doctor, saying it’s ok for him to take that much. Things got worse from there, but you get the picture. Even back then, pain pills were harder to find than a working payphone is now — for younger readers, a “pay phone” is like an analog Google voice that you have to use change to pay for… ah, shoot. For younger readers, “change” is a slang term for metal coins, used before smart phones and debit cards paid for everything.  Exhausting.

The struggle to receive pain meds

I have to say, though, this new hysteria over opioids has made things even more difficult and nowhere does it hurt more than during inpatient stays in the hospital. While my doctors were going from “oh it’s definitely just really bad acid reflux” to “it’s probably cancer and you might die,” I was sitting in my hospital bed, seething with rage because my pain level was slowly going from a 1 to an “I don’t give a sh*t about your f*cking pain chart just get me some drugs already!” Or, as the nurses and doctors called it, “requesting a consult from pain management.” Unfortunately, that was easier said than done, as there were approximately four pain management doctors for a hospital with more patients than some third-world countries. My first roommate, poor Joel, kept me awake every night screaming that he was in pain and needed more medication, and all they kept telling him was “we called pain management.” Needless to say, when I finally got moved to a private room, Joel was still waiting for that callback. I think poor Joel will meet his maker before pain management calls him back.  I knew it didn’t bode well for me, so the first thing we did when we got to the new room was request a meeting with one of the pain management doctors. Well, be careful what you wish for folks.

Before we go any further, I want to tell you that I have been on high dose opioid therapy for over ten years, and it has been clearly and thoroughly documented in my medical records. I have been under the guidance of two highly respected pain management doctors in New York City who work out of one of the most reputable hospitals in Manhattan for over a decade. I don’t get my meds from some shop-a-doc that I meet in a Costco parking lot who only takes cash and pulls up in an ’89 Buick Skylark with two different color doors and half a “Just say NO to drugs” bumper sticker. Amazingly, though, when the pain doc showed up, that’s exactly how she treated me (like the Buick guy not like the actual doctor guy). Strangely, her first question wasn’t “where does it hurt,” or “how badly does it hurt,” or even “what’s wrong with you?” Her first question was to ask me how had I filled my pain pill script for that month if I was in the hospital for the last three months. In other words, she was insinuating that something sinister was going on, and I was the Pablo Escobar of the surgical ward, with minions of drug mules out on the street doing my bidding, collecting my pain pills, and selling them in various crack houses around the city.

Seriously, I'm in pain

Well, I foiled her clever theory with a simple “my wife picked them up,” and before she could formulate the next ridiculous question I said “look, I need pain meds, and not a little, I can’t sleep, I’m in a ton of pain, oh, and, I HAVE A TUMOR INSIDE ME.” She was young, and I don’t think she had ever dealt with a "me" before, so she pretty much just walked out without resolution, and for sure I knew I’d be suffering through another night of sleepless Law and Order reruns. Fun fact — a Law and Order show is on some channel every single hour of the day, amazing what you learn in the hospital. I digress, though. Eventually, after another two days of fighting “big pain,” the hospital gave me a pain pump with liquid morphine. It did the trick and I was able to comfortably spend the rest of my time as an inpatient – until they took it away due to “shortages.” Ugh, the fight never ends.

So, as you can see, pain and cancer go hand in hand, but pain management and cancer don’t. It’s unconscionable the way that many cancer patients are treated like addicts when they ask for pain meds. I mean, if cancer doesn’t qualify you to get whatever opioids you need, then what does? Getting your head half eaten by a lion? Losing both legs in horrific Twister game accident? Being forced to watch “Keeping up with the Kardashians” for a week straight? Doctors need to stop watching the news so much and start listening to their patients. After all, what’s the point of pain meds if they cause pain instead of alleviating it?  Talk soon.