The drugs didn’t do this…he did!

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My husband’s death was not due to any drug.  It was his irresponsible USE of the drug.

With permission from an anonymous writer, I share the following e-mail which serves to illustrate that patients receiving opioids must be continuously assessed for compliance and that irresponsible behavior plays an important role in drug overdose.  Risk stratification prior to initiating opioids and ongoing assessments are important for safety and success.

This note comes from the spouse of the deceased.  Note, in this ironic case, the spouse is not blaming the prescriber or the drug overdose.  Perhaps this story gets to the crux of the matter; opioid prescribing and opioid use require a responsible patient and a responsible provider.  If either acts irresponsibly, the result can be disastrous.  But, if both act responsibly, the outcome could be life-saving.

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Dr. Fudin:

I read your post regarding media and politics influencing opioid panic and what struck me was that stories like mine are never reported or covered at all. 

In 2001, my husband died from an overdose of opiates and Xanax®. He had started on pain medications for pancreatitis, diabetes complications and in the end, he simply wasn’t responsible with his medication.  I spent nearly 8 years of my life flushing his meds down the toilet, throwing them out and pleading with him to stop using them so much.  I consistently wondered why he took more even when the pain was under control.  Of course, I learned that he was after much more than pain control.  

I am fully aware of the consequences of using these drugs without responsibility.  Our daughter was only 8 years old when he passed and I had to hold her for weeks when she shook and cried for her Dad. He was 39 years old and as far as I know, he was using the Duragesic Transdermal Patch®, removing the gel, and injecting it with the oral Xanax® at the time that he died. He would tell tales to doctors to get more refills, tell them that his wife flushed them away, which I did when I could. In short, I spent years watching him be irresponsible with these medications and our family did suffer a great deal.  

But here’s the thing, the drugs didn’t do this…he did.  

Personal responsibility is so lacking these days and he did make a choice to be so careless, I’m tired of hearing otherwise.  

That isn’t the end of it for me.  I’ve had viral cardiomyopathy since age 30 with an EF at the time of 19.  So I was left as a widow with two children to raise, and honestly could barely take care of myself. Now, years later, I am suffering chronic pain from several bulging discs, degenerative disc disease and arthritis. I think my spine has progressed far too much for my age of 44 and maybe because my heart has made the rest of my body decompose faster or just the hard work I’ve had to do.  At any rate, I went from walking an hour each day, bringing up my EF with time and medications to being barely able to stand to do the dishes.  Even a shower is pure torture for me.

I’ve been taking Lorcet® 10/650 three times a day for years now and they don’t work anymore so my doctor sent me to a pain clinic.  I was told that I was taking a huge amount of opiates and to try epidural steroid injections and Cymbalta®.  The ESI scares me to death; they said I have to stop my aspirin a week beforehand and may need more Bumex® for swelling afterward because I swelled up with Neurontin®.  

The Cymbalta® I simply refuse to take at all due to a bad reaction with Wellbutrin® years ago. I was sitting on the couch just staring at the wall and I vaguely heard my daughter calling for me. Like an echo, I couldn’t really be there or not, hard to explain.  Finally, she shrieked and woke me up out of the stupor of Wellbutrin®, Mom, where are you???  I immediately got up and discarded that bottle of Wellbutrin®· and called my doctor to tell him I won’t be taking it again.  I stand firm on this as those medications reduce my ability to be, well, me.  My faith in God was gone, I was erased…nowhere to be found.

My reason for letting you know my story is to tell someone, just anyone, how ironic it is to be me.  I couldn’t be a bigger advocate of using opiates in a responsible manner and yet I am treated by the medical community as some sort of high risk. My husband’s death was not due to any drug it was his irresponsible USE of the drug. And due to his actions and those of others who abused these drugs, patients like me are left to suffer without adequate relief.  My current dosage isn’t anywhere near a “high” dosage of opiates, I’m not sure if the doctor thought I would believe that or not.  Then again, I haven’t told this story to any of my doctors, fearing they would think of me the same as my husband that overdosed. After all, when the police came that morning to tell me he was dead…they also made me show them my arms to see if I was injecting drugs as well.  Talk about a hit in the stomach, I was just hit minutes before with the news of his death and had to do that.  I just can’t tell you how awful that was for me.

I’m a Christian and after much seeking on this issue and trying to find a reason for his overdose, I have come to the conclusion that it was a spiritual matter for him.  It wasn’t the drugs; it wasn’t a lack of some regulatory control.  It wasn’t anything but a heart condition of the spiritual sort.  At the very least it was a serious lack of personal control and responsibility.  Pills in a bottle or otherwise can’t jump up and kill you, it is only when a person decides to use them carelessly.  Why then do I have to suffer with pain that can be easily and responsibly controlled?  Why are all people in pain treated as if we are criminals, addicts and the fringes of society?  This is very ironic for me indeed!

Thank you for reading.  I pray that the medical community comes to see this as personal responsibility, not about the drugs themselves.  I probably won’t live long enough to benefit from any enlightened, compassionate treatment of pain but maybe the generations after us will have learned a lesson.

Sincerely,
Anonymous Irony

 

14 thoughts on “The drugs didn’t do this…he did!

  1. Thank You for writing about this it took a lot of courage. I have chronic Pain, and I am constantly treated like an idiot of drug addict by ignorant people in the Healthcare business. Some people are just irresponsible, or have a death wish, yet we get scrutinized and denied care. Many Doctors will only prescribe anti depressants, and other non opioid drugs , because they are too ignorant! I have a friend with CP who keeps getting ignored by the VA, they prescribed NSAIDS, and when they destroyed his GI tract they gave him something else, that caused him to grow one breast! One would think that would be alarming! This is the kind of Medical care that we can expect, because of ignorance and the so called “Drug War” When I tried to tell my former PCP about Chronic Pain, he told me about people being tortured in Iraq! I would gladly experience 24 hours of torture including getting all of my fingernails pulled out, if I could be pain free! They don’t het it!
    What we Chronic Pain Patients go through should be considered torture, and every time we are given the wrong meds or belittled it should be an actionable offense. If a stranger walked up and kicked me in the spine it would be Assault, yet that is how it feels every day, day in and day out! My meds give me limited relief! I have had nerve Ablation and other gruesome treatments that many people would never subject themselves to! I have been told my Pain is from “Hysteria” I thought that went out in the 50’s I consider that Misogynistic, and ignorant!
    They have contorted the Data regarding opioid deaths, lied to the American public, and increased the misery and dysfunction of millions of people. I was attending a university and working when my pain got really bad, and because of misdiagnosis I am now on disability I am unable to work!
    In my neighborhood most of the drug addicts have now switched from pills to real heroin! A Conspiracy Theorist would think they are supporting the drug cartels.
    None of the drug policy is based on empirical data, it is all old wives tales and nonsense!

  2. Thank you for writing this!!! I think more people should know about this!! I myself go to pain clinics and I HATE the looks I get from family and friends when they hear what I take. There is nothing wrong with me taking the meds! They help me and I take them as prescribed! Now if I take more or I start going overboard then you can say something!!!! This article has made my day! Thank you! And I am very sorry for your loss!

  3. I am grateful for her understanding that irresponsible behavior, not the meds, caused her husband’s death. However, her husband was not the only irresponsible one–his doctor(s) definitely played a role. My prayers are with her! I had a friend, an RN, who overdosed at work while shooting up Duragesic gel mixed with water. He was in his ’40s. What a waste! It breaks my heart to see that so many people with addictive behaviors make pain care so hard for the rest of us who have serious medical issues. I applaud “anonymous” for her candor, and believe she should be able to get appropriate pain care, as should pain patients who comply with testing.

  4. Its amazing how people that abuse opioids have taken everything away from people that really suffer from chronic pain.
    We cant change the way drug addicts abuse opioids because drug addicts don’t care to help themselves. Must all that suffer from chronic pain pay the ultimate price of losing what has helped us with our chronic pain over the years. Why is it people that suffer from chronic pain don’t have a problem with our medications yet we get blamed for the mistakes of people that abuse opioids.
    We’ve been kicked around, beaten down, rejected, injected with useless epidural injections that did more harm than good. We’ve followed all the rules only to be put in the same category of those that abuse all drugs. Why don’t we have laws in place protecting us, why is it drug abusers get away with ruining the lives of all that suffer from chronic pain. Maybe all of us that suffer from chronic pain should start our own Citizens Petition asking the FDA to leave in place the pain treatment program that enables us to be a responsible person of society.
    Its time all of us that suffer from chronic pain demand our rights, we must put laws in to place so all that suffer from chronic pain get the proper treatment for our chronic pain condition that we didn’t ask for…
    We cant let this out of control situation with drug abusers ruining things for us that suffer from never ending chronic pain. We’ve done nothing wrong other than follow all the rules only to be treating like dirt. Drug abusers don’t care about their health or us that suffer from chronic pain.
    They don’t work and want everything given to them or they will just steal the money they need for their bad habit. When will this travesty end and us that suffer from chronic pain have our right to live as pain free as we can without all this hassle. We must put in to place laws that protect all that suffer from chronic pain along with the doctors that but their career on the line to help us.
    We must put laws in to place to get drug abusers the help they need. They have ultimately ruined not just their life but the lives of all that suffer from chronic pain little by little over the years. If they don’t want to accept treatment then we’ve done all we know to do to help them get their life back on track.
    Don’t all of you think we that suffer from chronic pain have paid the price in pain over the years, its time we take back our right to be treated like a descent human beings, we never asked for this life full of never ending chronic pain.

    Mark S. Barletta

    1. Mark,

      I totally agree that we need to have rights as patients who suffer from chronic / intractable pain. I also agee that we deserve to be treated with dignity, respect, and compassion. However, keep in mind that not all drug addicts are unemployed, asking for hand-outs, and stealing. Some are wearing suits & making a great living, or they are grandmothers, athletes, students, soccer moms. Not all addicts look like druggies! This is part of the problem. To some people, anyone wanting / needing opioids is a “wolf wearing sheep’s clothes”. Part of the disease is to be as cunning, convincing, and believable as is required to get what they need. Any medical professional can tell you that they have been “burned” by drug addicts who presented themselves as honest, decent, reliable patients, who had chronic or acute pain that required opioids. Only to find out later, that granny was selling her pills, or the executive was shooting up, or the soccer mom was snorting them! The facade will eventually crumble, as they get further & further into their addiction…. In the meantime, they can present just like you and me…. Honest, suffering, people in pain.

      This is NOT an excuse for medical professionals to treat chronic pain patients as junkies, fakers, scammers, criminals, etc… It IS part if the reason that some do. They simply don’t know who they’re dealing with. I would HOPE that patients on stable doses of opioids, who their doctors & pharmacists know, and who have a proven track record of being responsible, would have SOME credibility, but these days, NO ONE seems to be given the benefit if the doubt. Patients SHOULD be treated respectfully and compassionately unless they have proven otherwise.

    2. There ARE pain laws on the books that protect patients suffering from chronic conditions. The problem is that most doctors dismiss them, they aren’t enforceable, and complaining about doctors who have mistreated you does nothing. Here is a summary of the laws on the books in California:
      http://www.anapsid.org/cnd/pain/calpainlaws.html

      I don’t see any way for chronic pain sufferers to receive adequate and proper representation in the media or in a doctor’s office. We have gotten lost in the arguments. We are all branded with the New Scarlet Letter – A (addicts), because to discontinue our meds would result in withdrawal symptoms. Withdrawal does not equal abuse.

  5. Its a shame that he done that sry to u and ur family. We are in the same boat as are a bunch of us and we agree ifmu use the medicines correctly there is no fear of overdose or death some people just dont know when to stop. I only wish my brother was responsible as well eventually he is gonna be dead too fornthe same reason. However there are legitimate pain sufferers that need meds and arenresponsibble with use. And more often than not we are truned away for help with pain. When these legislatures get a disease thats when it will change not before then for sures.

  6. Anonymous Irony,

    I am so sorry for your loss. It took great courage to share this your story. I like you, tell people all the time Medication did not cause a death when it is an overdose, it was a choice that person made. I have been a chronic pain patient for many years well over 20 yrs and if I find my medication is not working as well my doctor and I have a system, he will put me on a strong medication for 30 days and then ween me off that medication and then put me back what I was on or even a lower dose that way if the dosage needs to be increased WE can do so safely.

    I have never taken taken more than what was written on my bottle. If I was not getting the relief I needed I would call or go see my doctor. As I tell everyone if you are a Chronic Pain Patient you will NEVER be 100% pain free. I try and go off my medication or at the very least lower my dose myself. When taking Pain medication everyday it can mask other issue’s you would not even know you have as the pain medication is covering up that pain as well.

    I want to Thank you for telling your story and again I am so very sorry for your loss. God Bless you and your Children.

  7. OMG…..how horrific! I am SO sorry, you have been thru soooo much! But you are ABSOLUTELY right….it is misuse! I know people….like myself that NEVER run out early, lose scripts, etc, yet are DEPENDENT on their meds (also all my meds are locked up in a safe for safety)…..but I also know people that go thru their months worth of meds in a week then hit the streets buying whatever they can find, selling off everything for money, or stealing, etc…..THEY are ADDICTS……HUGE DIFFERENCE!!!!

    I have to sign a contract, take UA’s, and go in monthly to get my scripts. Of course, there has to be guidelines…..but everybody is NOT an addict…..addiction is something IN someone. But those of us with intractable pain should not be PUNISHED for the actions of others…..and we should not be forced into invasive treatments that don’t work! How can the government….that NEVER see us…..know better how to treat us and our pain better than our doctors that some of us have seen every month for a decade or more! Who do THEY think they are????? UNBELIEVABLE!!!

  8. Thank you for your story, Anonymous Irony. What a tremendous loss for your family. I completely agree that over regulation & opioid label changes will have no effect on prescription opioid addiction and overdose. Treating patients with legitimate pain like drug addicts, and under treating pain, will also not help.

    I’m not letting your husband “off the hook” for his actions, but I will say that addiction is a DISEASE. It was NOT the drugs that killed him, and it wasn’t necessarily his “irresponsibility” that killed him. It was his relationship with opioids that killed him. There are some people who develop a compulsion and craving that is triggered by ingesting certain substances. In many cases of true addiction, that compulsion to use is stronger and more powerful than any common sense, logic, or sanity. It is also more powerful than the love he felt for you, your daughter, or himself.

    It is why alcoholics cannot have ONE drink, and call it a night. it is where the expression, “one is too many, and a hundred is not enough” came from. My guess is that your husband could NOT control his behavior. Unfortuneatly, his bottom was death. For others, it comes when they are ready, at a crossroads, have a spiritual awakening of sorts, and get HELP.

    I feel incredibly sad for you and your daughter, but I also feel sad for him. He was unable to stop, and craving, compulsion, and the insanity of addiction killed him. The fact that he had legitimate pain, made it even more complex and difficult for him to stop.

    People either have this addiction, or they don’t. The majority of chronic pain patients DON’T. Unfortuneatly,,because there is such little understanding about the disease of addiction, ANYONE and EVERYONE who is prescribed an opioid, is considered a suspect. That is ludicrous ! Most addicts will show their colors shortly after being exposed to what it is they are addicted to. They will break contracts, not be able to stay within the prescribing guidelines, use other substances, or claim to have their meds. , ” stolen or lost” regularly.

    Yes, we need to have monitoring, proper patient selection, etc… However, sometimes people should be given the benefit of the doubt when they suffer from serious pain. If they are going to have an addiction issue, it will present itself soon enough. THAT’S when people need to be referred for drug treatment, and hopefully begin to process of recovery. If not, they will continue to use any and all substances that they crave. Government policies and regulations will NOT stop them from using. Keeping opioids away from everyone, will NOT stop them from using. Denying opioid treatment from EVERYONE with chronic pain will do NOTHING but create more suffering….

    No one wants irresponsible opioid prescribing. No one wants irresponsible opioid use. No one WANTS to become a drug addict, either. So, let’s treat addiction for what it is…. A disease. A disease that needs specialized, available, accessible treatment. Lets also treat serious pain conditions, as the medical conditions that THEY are, by prescribing opioids when appropriate. Let’s STOP assuming that chronic pain patient on opioids = drug addict. is there some overlap between these two groups? Yes! Is there such overlap that we should BAN opioids for chronic pain, treat human beings with serious medical conditions as drug addicts, suspects, and criminals…. NO.

  9. Doc Jeff, I’m so sorry when I hear stories like this. The question that I have is this, “was he being monitored correctly? It seems he wasn’t. He told stories to his Doctors, and got more medications, in turn. Was he being regulated by “urine tests, counting his meds, etc.” I see that the wife was flushing them, but they needed to follow this guy closer. The pain from Pancreatitis is a monster. So are the complications of diabetes. I was an RN for many years, as you know, and this guy looked like he was a guy that just fell through the cracks. With all his problems, the Docs were just loading him up. When a patient goes to their doctor with such problems, some of the docs just look at his chart and prescribe whatever he wants. Especially if they know him, and have been treating him. It’s such a horror when this happens. The poor young daughter, wondering what happened to her Daddy.
    The thing is , with a patient with such iretractable non cancer pain should be monitered so closely. When I go to the Doc, and I have Arachnoiditis, as I have stated before, I have my meds counted, I have to give a urine test, and my meds are given monthly. There is no room for BS, with these drugs, and I know that’s what you have been fighting for.
    I just hate to see stories like this, but it’s necessary . It show’s that some patients are just falling through the cracks. They aren’t being watched. Scraping the gel of a patch, and shooting himself up with xanax? Why , why does this happen? Then, people like, ANDY, and me, at one time, are prescribed “Anti seizure meds, and ridiculous FAKE antidepressants. If someone, like this wife and their are many more out there don’t tell their stories to the FDA, we are gonna wind up with this uncontrollable pain. I pray this doesn’t happen. Thanks Dr. Jeff.

  10. Thank you for sharing your sad and touching story. It is refreshing to hear the words “personal responsibility.” That is what is missing today.

    “The difference between the poison and the cure is the dose” in the wise words of Paracelsus.

    Punishing legitimate and responsible pain sufferers and treating them like addicts will not address the issues of those who use opioids irresponsibly. And the latter will always be with us. Look at alcohol prohibition. No drunk was prevented from drinking just because the good people could not legally purchase spirits. It is the ultimate fool’s errand to try to make this world perfectly safe for the foolish and irresponsible among us.

    Leave legitimate pain sufferers alone. No amount of lashing out at responsible people will stop addiction and abuse among the irresponsible.

  11. Anonymous Irony

    My heart breaks for your family, but I applaud your spirit and ability to see reality for the way it really was. I only wish more people would stop blaming everyone BUT the person breaking their contracts, the law, and choosing to potentially put themselves at risk.

    As a chronic pain patient, I have very little sympathy for those that CHOOSE to abuse their medications, and less sympathy for the family as they typically witness the behavior but don’t take steps like you did (flushing his medications) or just ignoring it, and then blaming it on a Dr. that sees the patient once a month. Addicts will find their medications one way or another. Chronic pain patients do NOT have that option.

    Perhaps I am fortunate that I can control my medications, but I know it is life or death; If I run out early my quality of life would be diminished, and I am not about to put myself at greater risk doing ‘drug seeking’ behavior’. Though I wonder, if they continue to try and pass these “limits” and “90 day supply”, what are those that depend on this medication for life going to be forced to do? The govt has no business on dictating treatments–whether it is for cancer treatment, pain treatment, or heart disease.

    Sorry again for your loss.

  12. This is what I have been saying for a long time now. Very powerful testimony. I wish the author of the email testified in front of the FDA. I suspect the FDA will have another hearing if they move forward with some labeling change. Hopefully, the email author will be able to go. I also hope the author gets good pain relief soon. I had to change doctors a few times until I found one willing to prescribe the necessary medicines. I tried every anticonvulsant and antidepressant for my pain and they either gave me terrible intolerable side effects or didn’t work. Yet, many doctors told me that is all they would prescribe. Opioid pain medicines work excellent for me and I have no side effects, yet a lot of doctors wanted me to be in pain and sick with side effects because of unfounded fears about addiction and opioids.

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