When suicide becomes the option due to the opioid epidemic

When suicide becomes the option due to the opioid epidemic

I have been involved in the suicide prevention things for the past eleven years or so. I have been reading research articles from those in the field. Then I became disabled and my suicidality increased but I have not made any attempts. The reason I say this is because I am now involved in the chronic pain community and found that there have been a lot of suicides since the crack down on opioids really started bearing down on patients and their doctors.

Recently there has been a woman in Montana that ended her life after the DEA went after her doctor. I find this, sadly, preventable. These pain patients have severe pain and need opioids to get relief. Since October, I have been trying to get adequate pain meds to relieve my pain but have been facing nothing but red tape. I have had two psych hospitalizations, which have not been helpful in the least. My psychiatrist is really worried about me. I have a plan to end things in a few months. It is a coping mechanism for me to make these plans. I don’t know if I will go through with it but it’s helpful for me to know there is an end to my suffering.

In the suicide prevention community, specifically a social media twitter group called SPSM (suicide prevention social media) there has been a lot of talk about getting the medical professionals to talk openly about asking about suicide as there has been research stating most suicides happen a within a period of time after seeking a medical professional. I argue that the psych professionals also have to ask the question, which sometimes does not happen for a variety of reasons. What is missing in those with chronic pain, is also lacking the talk of asking about suicide after pain meds have been forcibly cut or stopped all together. This kind of action has lead to multiple suicide that Dr. Kline, a pain physician, has written about.

I really think that if the pain psychologist in these pain clinics ask about it or even the health care professionals do, there might be a chance of saving a life. These patients feel their backs are against a wall and they cannot function without these meds anymore. The epidemic is nothing but hysteria. The CDC lied about their statistics and made it look like prescription opioids were the problem when it was really illicit drugs. Compounding the problem with chronic pain patients not getting the meds they need are the patients that have substance abuse disorder. The stigma surrounding substance abuse is probably as bad as those with suicidal ideation. There are no easy answers as some chronic pain patients has been grouped with the substance use and vice versa. Both need to be treated with meds but stigma and thoughts of not being able to be “strong” enough to stand the withdrawals or handle pain is just not a way of doing it. Unlike alcohol abuse where abstinence helps, substance use need medical assisted treatment with meds such as suboxone. There needs to be no legal punishment for those seeking treatment. More overdoses have happened due to people being released from jail and then using again because their tolerance has been lowered while being away from their substance.

With chronic pain, those that have been stable for years and being taken off abruptly, often turn to suicide because their pain is making their lives miserable. They can no longer do the things they did while on pain meds for their chronic pain. Often these patients feel abandoned by their doctors and some have been and are unable to find another doctor to treat them. Some have to travel far from their homes for care. It is a sad situation. Pain needs to be addressed. It was the 5th vital sign but the crisis has done away with it. So those with deep emotional pain don’t get asked about suicide and those with deep physical pain are neglected and never asked about their suicidal thoughts. Can we bridge this huge gap? Tough question to be answered.

Not having a good night, bitch rant

I wrote this to my psych. I think I am getting hypo as I haven’t been sleeping the past few nights. Hope it is just because of this stupid flare…

Not having a good night. Major flare where high ankle down to my toes were twitching and setting off anxiety. Then my foot felt like it was a balloon ready to pop. It wasn’t swollen. I carefully touched the top of my foot and it felt really odd, like dead skin but not dry. Maybe fragile is the word. Standing has been a huge problem. Just causes pain. Sometimes I can walk it off and sometimes when I sit back down, i hurt more. I was so overwhelmed and was tempted to page you but didn’t want to bother you with my craziness. So many different pains and sensations were overloading me. It is a little better now but I still hurt. Every time I move pain shoots up again or feels like it is going to cramp, despite the 1 mg of Ativan I took at bedtime. I took 10 mg of baclofen to try and stop the twitching/cramps. Also took 1000 mg of magnesium. I think i need to increase taking the mag for a while. Just hope it doesn’t cause bowel problems. I’ve been leaking urine more so that has been fun. Need to shower more which is difficult when you can’t stand.

I ended the email here, telling her to delete it. I was very scared with all this. The skin issue really is gross. It doesn’t feel like my skin. Then I have a golf ball swelling of malleolus. I rubbed that tonight. It hurt so I stopped. I thought about using lidocaine but wasn’t sure if touching it would set off more twitching.

It is now 1 am. Every time I take off my glasses to lay down, I need to put them back on to read something. My eyesight is bad. I can no longer read my phone without my glasses. I have an upcoming eye appt. It is with a new eye doc as my doc retired. I miss him. I got to change the appt. I got so many calls to make tomorrow and I need to get my haircut. I am going to get a bald cut but leave the top like a flat top. I want to try and have spiked hair by the time my cousin’s wedding comes around in June, if I don’t kill myself from this fucking pain first. I still can’t believe the psychologist wanted to taper my fucking meds! Would he do the same to a diabetic on insulin? I mean seriously!! I am so annoyed. I don’t think I’ll be able to keep my meds with this stupid opioid epidemic going on. Chronic pain patients are the ones that are going to be the genocide of the “epidemic”. Apparently politicians are taking away the 1st do no harm from docs by tying their hands. It is either don’t prescribe or lose your license. What kind of medicine is that?

a little bit of everything Monday

A little of everything Monday

I got about 5 hours sleep. I then went to Starbucks after making a PB&J sandwich for lunch. I ordered 6 shots of espresso and a donut. I wrote a little bit before I had to leave to see my psychiatrist. I kind of left early so had like a half hour to kill. I didn’t want to check in that early so I just found a bench outside the office and wrote a little more in my journal.

The appt did not go very well. I told her about having to go through withdrawal last week because I was late in taking my pain meds and she called me an addict. I tried to correct her saying I was dependent but it fell on deaf ears. She kept repeating addict and it make me hurt so bad. I seriously didn’t expect this from someone I have known nearly 25 years. She was being ignorant but it hurt none the less. I vented to my support group about it. I would school her later.

After the appt, I went to the Sprint store to change my name now that I have changed my license. It took maybe 10 mins. Crap. I still had like 2 hours before I had therapy. I went to a Starbucks by my therapist’s office and just ordered hot water for tea. I made Earl Grey. I waited for it to cool so I wouldn’t burn myself. The water was wicked hot. I wrote in my journal about what my psychiatrist had said. I then posted to a Facebook pain group if they had any information about the difference between addiction and dependence. The bathroom at Starbucks was out of order so I left to go to my therapist office. All the drinking fluids was building up and needed relieving. I just made it to the bathroom in time.

Therapy sucked. I told him about what my psych said and he said I should ask her what she meant. After discussing that, I just rambled about anything to make the time pass. I didn’t bring up mommy and daddy issues but the idiot asked me again what was my pain like. I swear he thinks I am making shit up. I told him it varies and depends on where the pain is. It is usually half my foot/ankle going outward starting about the 3rd toe. I told him I got depressed and hopeless and it was hard to keep up the mental stuff with the PT exercises the PT gave me. He said just do them. Yeah, cause it is that fucking easy. Are you serious?? He just annoyed me more than my psych ever did in all the years we worked together.

I get home and on the way, my cousin called me. He was unable to call the bank like he said he would to get information for me. Lazy ass. He said he would tomorrow. Sure, and I will win the lottery too. His mother really irked me because she called me while I was on my way to my psych appt. She wanted to know if my mother was okay. I told her she had to go to the bank, which her brother was going to take her. My mother wasn’t answering the phone. Well, maybe she was in the bathroom getting ready or taking a shit. I don’t know, I am not home. She got me fricken worried and all worked up. My psych sensed it when she saw me. I told her I would call my mother when I left as I was sure she was fine. She was. She was out and did some errands, which she obviously didn’t tell her sister. HOW DARE SHE! LOL fucking stupid bitch my aunt is. Freaks out all the fucking time over NOTHING!! I was so heated!

I get home and had something to eat before going to my room. I had a pile of mail. I brought it up to my room and then checked Facebook. The pain page responded with some links. I clicked on one and there was another link for a medical article on addiction and dependence. I opened it and read some of it. According to the article, because my pain is not adequately treated, I would have pseudoaddiction, where I watch the clock and appear “drug seeking” for relief of pain. I sent the PDF (attached to this blog APS_consensus_document here) to my psych along with saying that I felt hurt when she called me an addict. Then the tears flowed and I was a sobbing mess. It took me a good while to get composure. Then she responded and I bawled again. Fuck. She said it was not her intention to hurt me and that she didn’t want me to be dependent on the narcotics. Too late for that. And for that matter, I am dependent on my mood stabilizer, which I responded back to. I told her I didn’t want to be on opioids but the benefits outweighed the risk. I knew and accepted this just like I knew I needed meds for my mental illness. I told her the example of how I withdrew when I forgot to take my mood stabilizer for two days when my father was ill. I honestly didn’t think anything would happen but I had the same type of dizzy spell I had last week when I missed my pain med dose.

No one wants to be dependent on their meds but it happens to the best of us. I knew when I was 16 I would need to be on meds the rest of my life. There was no doubt about it. I had severe mental illness and the only way to manage it was through medication and therapy. Unfortunately, the therapy part hasn’t worked out yet. I can’t say I am cured, because I still have bouts of debilitating depression and suicidality. But lately, the pain has fucked up everything. Now I am depressed and suicidal due to a medical condition, Complex Regional Pain Syndrome. And there is no fucking way to control it because it is as unpredictable as the New England weather. I don’t even have the same pain twice during a flare up. It is all fucking different as night is to day. The only type of pain that is somewhat consistent is the fucking malleolus pain and the pain that is where my outward ankle and foot merge, just under the malleolus moving toward the foot. This pain drives me up the fucking wall. I had to text the Crisis Text line last night because I needed someone to talk to at 0100. I didn’t get a “counselor” till 0200. By then, I was sleepy and hungry. I made something to eat and then I said night to the “counselor”. The whole thing was useless. She kept wanting me to do some coping skills. I kept wanting to talk about dying. She didn’t want to hear it. How is that helpful?? Next time, I just write in my journal or maybe blog and hope the cops don’t show up at my door.

The temp dropped to 32 degrees. I had to shut the window because it was flipping freezing in my room. My feet got cold as ice so had to put on thermal socks. Then I had to use the bathroom again. I figure I would take my night meds when I came back to my room. My mother wanted me to make her bed. I did. Then got tucked back to my bed only to realize I didn’t take my night meds! Fuck. My ankle didn’t like me getting up again. I quickly took them and then got back under the covers. I put on a long sleeved T shirt. If the heat kicked on, I will take it off. Shit my foot is burning right now. Neurontin time!

Oh, while I met with my psych, we discussed the drug Vimpat. I wanted to make sure there were no interactions with the Trileptal as they both work on the same sodium channel thing. Last thing I need is my sodium (blood salt) to drop. She was okay with me trying it so I emailed the neurologist to go ahead and call it in. He hasn’t so far. The script for a refill of Trileptal my psych put it, never made it to the pharmacy. I had to email her again. For some reason, it had to be reviewed by the pharmacist so it is delayed. I’ve been on this med for over 10 years. If it is not ready for pick up tomorrow, I am calling to find out why it is not ready. If I didn’t have all my meds at this pharmacy, I would switch to another one. But this one is the closest to me and has better service than Rite Aid.

Thanksgiving 2017

Thanksgiving 2017

I woke up around 3, my foot still ablaze in pain. I somehow managed to go back to sleep and then woke up at 11. I only got up because my bladder said I had to. Holy pain!! I barely made it to the bathroom. I wanted to brush my teeth but I couldn’t stand too long. I went up to my room and took pain meds. I really just wanted to stay in my bed all day but knew that wouldn’t fly with today being a holiday.

I went back to sleep for a bit. My brother in law never replaced my ceiling fan. He was on call at his work and of course, got called in, three times! Guess there were problems with water heaters. My sister called me to say dinner was ready around 1400. I put the boot on and went to my sister’s. I am glad I didn’t have to leave the house. By the time I came down, everyone had made a plate. I made one and then sat down at the table. My goofy sister wanted everyone to go around and say what we were thankful for. When it was her turn, she kept on being a goof and so was naming everything and anything. The turkey was made by niece. It was ok, though I like when my mother makes it. I later found out she put in a clove of garlic. That was why it tasted different. I was so full for dessert but had a cup of tea and some pumpkin pie. The other pies that my brother in law bought were not good. He said he is going to take them back. I hope he gets a credit for them. They were terrible. The apple pie dough was not cooked!

My mother went upstairs after dessert. We were all just hanging out when we heard a thump. We asked my niece to go upstairs to check on my mother. She was moaning so we all went upstairs. She had tripped over a chair and fell on her knee replacement knee. It bruised up right away. My brother in law helped get her up and then we all helped her to the living room. She won’t be going upstairs to her room tonight. She is really sore. I feel really bad she is hurting so much. I gave her some ibuprofen right away to help with pain and inflammation. She is icing it but can only do it for short periods as it hurts to touch it. She has neuropathy from the diabetes so touching any part of her leg hurts her. I just finished putting a sheet on the couch, getting my mother’s night meds, and her pillow for her. My foot is thanking me in HUGE shocks of pain.

Other than helping my mother around the house tomorrow, I am not planning on doing anything else. I am going to try and stay off my foot or be in the boot if I have to be walking around the house. My foot/ankle just don’t want to move the way they should and if I try to, they hurt like hell.

The radiology report is finally in my online records where I could read it. Doesn’t sound too good. I don’t know if my bones are going to get worse over time or not. Never know with CRPS. I know that it could spread, either up my leg or to other areas of my body or even to my body itself. There are a few people in my UK support group that have it in their organs. It is a very painful condition. It also looks like the “opioid epidemic” is not just in the US but in the UK as well. Someone in the support group said their pain doc just told her her body is “fine” and that she doesn’t need pain meds. Even her GP, who doesn’t know her, cut her pills. I hope she is able to find another doctor that can help her and treat her pain. I would kill myself if I didn’t have the few pills that I have. I know that I want to be put on a longer acting pain medication for night time, but don’t know if I ever will. The chances of me having to increase the strong pain pill dose might happen down the line. I try not to take it but it seems to be helping with this bone pain that isn’t being helped by the regular pain meds. My psychiatrist thinks I should be on methadone for pain control but I really don’t know anyone on it for that. I just know of people with substance use disorders who take it. She has wanted me to be on this drug for a long time. I honestly don’t want to be on it because I don’t think it will help me. I know some people in the UK are on low doses of naltrexone (LDN), which is also used for substance use disorders but in larger doses. I don’t think LDN is used in the US and only certain doctors can prescribe it. What kind of doctors those are, I have no clue. I am guessing substance use treatment doctors, which are a handful of docs. It’s so weird that they want you to be treated for being addicted to opioids, like heroin and illicit Fentanyl, but your primary care doctor cannot prescribe this medicine to treat them. They need to see a specialist or go to a treatment center of some kind to get these meds. And the stigma surrounding addiction furthers prevents seeking help because there is the mentality that it is not a disease, but a character flaw, which is utter bullshit. Addiction is a disease, unfortunate, but with the right help, people can be clean and lead productive lives. Unfortunately, chronic pain patients are the ones suffering because we need the opioids for our pain and do so legally yet are monitored more closely by government officials than doctors. This is because they know heroin, which is an opioid, is not regulated so they can’t go after dealers or those that use it. People don’t go to the pharmacy for those meds. Just sucks because I know one day my meds will be cut off because of politics and my doctor will sign my death certificate. Not the politician, but my doctor who treats my pain. Pisses me off.