Not Your Average Drug User The Hidden Downfalls of the Opioid Epidemic

[Music]

what

constitutes an identity

are jobs our values

our passions who we love

for someone like me who is almost a

completely different person today

than who i was just a few short years

ago i struggled to define myself

but here’s what i’ve come up with so far

i am a lover of people a proud nerd

an accomplished academic and drug user

i am a drug user and opioids are my drug

of choice

this is my story

nearly four years ago my life changed in

a big way i had just gone into grad

school at the university of toronto

and was doing my best to keep up with my

new environment

at the time i had gone from serving

tables at a local restaurant

to now spending several hours a day

studying the inner workings of brain

cells

something i knew really nothing about i

didn’t have a very comprehensive

background in science

not like my peers did at least so while

my colleagues were full steam ahead

running their experiments

i was playing catch-up with my head in

the text books trying to learn basic

terms

grad school stressed me out mostly

because i couldn’t keep up with the

expectation that

in a matter of only a few years i was to

become an expert on something

i didn’t even grasp the fundamentals of

so i cope with my stress

the only way i knew how working out

lifting weights was a long time passion

of mine and the rush that came along

with pushing myself to my limits

was truly therapeutic for preventing my

frustration and stress

and so as my days at the lab got longer

so did my night to the gym

and i’d often spend two or three hours

working out

sometimes back to back for days in a row

i was as strong as i’ve ever been

with such frequent and intense workouts

i was used to feeling sore

pretty much all the time but i had

started to notice something very

different about the way my body was

acting

first i noticed pain in my back

and it wasn’t the muscle soreness that i

was used to

this was pain and i wasn’t going away

after workouts

i also found myself to be way more

fatigued than i ever was before

and whereas my friends only needed a day

or two to get back to the gym

i needed several sometimes weeks off

just to recuperate

at first i wasn’t worried and figured i

was probably

just experiencing an injury maybe

brought on by the stress of grad school

so i stopped working out but as weeks

turned into months

of 24 7 around-the-clock pain

i grew increasingly more concerned

eventually enough time had passed that i

was realizing that i was staring down

the

path of chronic pain a very dark path

path often with no return a path

i was familiar with because i had seen

someone walk it before

my own father when he was left in

debilitating neuropathic chronic pain

following a stroke

i had seen what chronic pain could do to

someone

and i was terrified that i was next

because i wasn’t sure i could survive

so i did everything in my power to fix

my situation

i made lifestyle changes moved downtown

onto campus

so i wouldn’t have to tote around a

heavy backpack and commute

i got a new mattress i was relentless

with

physio and chiropractic work did plenty

of massage and

even tried naturopathy my room filled up

with

contraptions some which hung me from my

feet

others that stretched me out then and my

closet became a clutter place of

rolling balls and exercise mats heating

pads

i got every supplement i could find on

the internet

i tried every topical i even read every

book i could find on

healing my back pain with my mind but it

was all to no avail

as my savings dwindled my desperation

pete

all the while only one thing remained

true and constant in my life

pain but i was getting worse

after about a year the pain had spread

first from my back into my shoulders and

neck and then into my arms and legs

until my entire body was enveloped by

that

point nearly every muscle ached

every joint throbbed mundane tasks that

i took for granted

became near impossible things like

going for a walk or going up a flight of

stairs were

tough because my back was in so much

pain it couldn’t hold itself

up my feet would seize up and i would be

left bedridden for days barely able to

make it to the washroom just down the

hall

even my hands became so sore and my

knuckle so

stiff that texting was painful

these daily tasks that were nothing

before were leaving me in

agony even sleep was eventually taken

from me

and most of my nights were spent balled

up on the floor writhing in pain

usually over a roll or a ball

waiting for the sun to come up while the

rest of the world slept

showers became nothing more than a

hiding place

a place of camouflage somewhere i could

go and

rest my head against the cold tile and

cry

hoping that no one would hear me over

the sounds of the water droplets hitting

the floor

by my second year of grad school i was

inconsolable

life had gone on in the background and

family events

birthdays flew by without me hardly

noticing

yet what was only a two-year anniversary

of chronic pain

felt like a lifetime i felt like

i was living life on repeat in the worst

way

like i was going through a groundhog day

from hell

i had all of the opportunities of the

world in front of me

yet was too broken to reach for them

along the way my days became less of

looking at brain cells through the

microscope

and more of watching the clock in the

waiting room of various doctors offices

doctors all agreed that something was

very wrong

that i had some disease but they

couldn’t agree on a diagnosis

and in the meantime my life was hanging

in the balance

literally finally

i got to see a pain specialist who

unbeknownst to him

was my last hope i’ll never forget

our first consultation after we met

and i told him about my condition we

shook hands

and he showed me to the door but before

i left i stopped

and asked him a question that had been

on my mind for months

i asked if this ever gets better

desperately clinging on to the hope that

perhaps this could be fixed

and he looked at me with as much

compassion as helplessness

and he said no this is for life

you’re a chronic pain patient now

i booked it out of his office feeling my

heart race and my eyes well up

i made it to my car where i locked the

door and i punched the steering wheel

over and over again and i

wept i didn’t know if i had been handed

a life sentence or a death sentence

i didn’t know how long it would be until

i couldn’t go on anymore

i didn’t know how long it would be until

i would be in that car seat again

crying over the steering wheel with the

window rolled down

and the car running in the garage

when we injure pain there’s only one

coping mechanism at our disposal

the notion that pain is temporary that’s

how we get through

knowing that there is a light at the end

of the tunnel

but what happens when there is only

darkness

what happens when suffering knows no end

what happens when that coping mechanism

is robbed from us

how long can the human spirit endure

before

it has fundamentally shattered

how long could i have gone on before i

could on

no more with my pain doctor beside me

i started the long and exhausting road

of medicating

first with only a few drugs but then

several

as if grad school wasn’t hard enough i

was now dealing with a constantly

changing cocktail of drugs and all the

side effects that came along with them

but i bit my tongue and i didn’t

complain because i was desperate to get

better

but still dozens of drugs later nothing

worked

and things came to a head again when i

went back to my doctor’s office and let

him know that my will to live

was hanging by a damn thread

it was only then after we had tried

everything else that he made a call that

would eventually change my life forever

he prescribed me opioids

i went home with that prescription in

hand that night and i thought about all

of the things i had worked for and how

they were now at risk for being

destroyed

i was terrified of these drugs i didn’t

want to be

a statistic of overdose i didn’t want to

be found

shooting heroin on the street but this

was

not a choice to be made this was

survival

and with that in mind i popped the cap

i double checked the label and i took

the pill

life on opioids caught me by surprise

i was sure i would be groggy and

unmotivated and fatigued as it had been

for months before but it was the

opposite

i had energy i was alive i was happy

the pain was still there but it was

quieter

it was like the chains had been loosened

just enough

just enough to sleep just enough to eat

just enough to live i was able to

pick up the pieces of my previous self

and rebuild a new normal

a new normal that let me get back to

work and finish my degree

and run scholarships of the provincial

and national level along the way

mentor students and even get back to

working out

but my success was short-lived

it wasn’t long before i became well

acquainted with the problems

of opioids they stopped working

i thought my fears creeping back in

knowing i didn’t have a back-up plan

but luckily my doctor did for example he

introduced me to opioid rotation which

essentially

capitalizes on the limited tolerance

of the opioid class and by switching or

rotating between

various opioid drugs at equivalent doses

a patient can maintain sensitivity for a

prolonged period of time

opioid rotation has been a massive asset

in my recovery but it hasn’t been

everything

because as it turns out dose sensitivity

is only a small part of a much

bigger problem rather

the inability to get a effective dose

posed a much greater threat to my pain

management

in response to the opioid epidemic gone

are the days of gradually increasing

doses over time

in order to try and combat the

inevitable tolerance which occurs

instead the canadian government

implements strict restrictions on the

maximum dose a patient may receive

irrespective of their pain level or

condition

the problem is that this dose is simply

too low

for many patients including myself who

even at the

maximum dose will not find adequate pain

relief whatsoever

nearly all others will reach opioid

tolerance so quickly that they will have

nowhere else to run thereafter

doctors must adhere to these guidelines

or risk having their practice

taken away from them and thus they

cannot dose as they see needed

ultimately this leads to prescription of

other medications

many which do not show strong effects

for pain management

in order to try and compensate for the

few opiates they may prescribe

this leaves pain patients who are

already suffering

to deal with the side effects of

polypharmacy

much like i had to what’s worse

as this has created a massive divide

amongst patients who were grandfathered

into opioid therapy

people like my father and those of us

who came later

people like myself to give you an idea

of the discrepancy between these two

groups

the maximum dose a patient may receive

is 90 milligrams of morphine

this is the dose that i’m at now and

will stay out for the rest of my life

even when this dose completely stops

working

which it almost has yet my father will

receive a dose that is 15 times that

amount for the rest of his life

think about that the opioid cab was

introduced to try and protect those who

would potentially succumb

to the dangers of the opiate epidemic

but it has only created bigger problems

opi prescriptions continue to make their

way to the street where they are abused

and yet the street has only become a

more attractive option for

a desperate pain patient looking to seek

relief

while the opiate epidemic continues to

rage on

a second opioid crisis has formed one

that you are not aware of but that i

am one where thousands of patients are

left empty-handed

while some people are dying of opiate

overdose others are left to suffer with

opioid inadequacies

this is an example of stigma permeating

law

the notion that a blanket restriction

must be put in place to protect the

lives

of those who decide to abuse their drugs

is akin to the war

on drugs effect on medical cannabis

users

the parallels are clear a drug that is

abused by some gets restricted for all

pain is dynamic and thus our treatment

ought to be as well

there are infinite diseases conditions

and injuries all can which cause

different levels of pain types of pain

and frequency of pain

if this is true then we need to adjust

our system because

a blanket solution that we have now is

not a solution at all

we cannot continue to allow responsible

chronic pain patients

to pay for the acts of the reckless

anything less than

an individualized approach to managing

pain is

cruel and inhumane but it doesn’t have

to be this way

there is a solution here in addressing

both of the opioid epidemics responsibly

integration of opioid rotation frequent

use of drug testing

blacklisting those who do abuse drugs

and using psychiatric evaluations before

prescribing to assess risk of abuse are

only some of the ways that we can

address the opioid epidemic

without punishing those who rely on

these drugs to survive

at the very least we as a society must

rethink these drugs and destigmatize

them and not always understand them as

being toxic and poisonous

but as therapeutic and life-saving for

those who are left

no choice but to suffer with pain for

the rest of their life through no fault

of their own

at first glance i may not seem like your

average drug user

but in many respects i am

i am not an anomaly i am only one of

millions of patients

who are suffering in pain and just

trying to live a responsible

normal life we are all around you

but because pain is silent society

remains non-privy to our suffering

yet we are losing access to our only

lifelines

desperately waiting for someone to throw

us a rope

thank you

you