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