Tuesday, 11 April 2017

Opinion: Where addiction and tragedy can confuse issues

It is a sad story
I just read an article posted on LinkedIn titled, Opioids, My Mom's Death, and Why People Trust Science Less and the human side of the story is very sad, however, the additional narrative is opinion, conjecture, suspect and unfortunate.
There is a conflation of issues along with unresolved conflicts that need to be separated before this article tagged as an Editor’s Pick, Healthcare and Pharmaceutical are taken in without questioning or review.
Separate the issues
Walking back the issues, there is grief at a mother’s death, addiction to pain-killers that came as a result of prophylaxis for osteoporosis, estrangement, and then the machinations of the pharmaceutical industrial complex, known as Big-Pharma.
There is no doubt that Big-Pharma, Big-Tobacco, Big-Oil, Big-Manufacturing, Big-Agriculture and Big-Anything have a lot to answer for about their products and the effects of the production and use of those products on people, on the environment, and everything that makes for the wellbeing of our common humanity, but that is addressing the symptom.
The fundamentals would always be down to the individual, their personality and their experiences in how persuadable they are and this is not to castigate the strength of character of anyone, but missing that point would allow for drawing the wrong conclusions.
Scientific advancement has done wonders
For instance, it is thanks to the contributions of scientific research and medicine that I am alive today, having at one time been at death’s door with a prognosis of 5 weeks to live if my physiology could not tolerate and respond to the regimen of therapy I was being prescribed.
At the lowest point, I was in such unbearable pain that if not for the need to monitor my vitals, I would have been anaesthetised to manage the stress of it. Before I was admitted to the hospital, I was on Tramadol, then on the day I was admitted, I was given a morphine skin patch that had to be taken off after two days because I could not keep my food down and from then on, I was put on Oxycontin and Paracetamol with Codeine.
Whilst it appeared to manage the pain, when a deep biopsy was done on the fungating tumours under the sole of my left foot, 7 shots of local anaesthetic did very little to deaden to the pain. I simply bit on a think piece of a folded napkin as they prodded the anger in my foot.
Managing pain alone
On leaving the hospital, I was prescribed a list of pain and nausea management drugs that I was concerned about the cumulative soporific effects of the drugs. In addition to the earlier prescribed drugs, I was given a Fentanyl patch and that dosage was doubled when I reported that I was still in very much pain. That was when the equilibrium for my pain management was reached, I was not as pre-occupied with the pain as I took in 7 sessions of chemotherapy and the cancer lesions healed.
Whilst the lesions had gone and all the necrotised skin had been removed to reveal fresh skin, I was still in pain into the 4th month of my diagnosis, then the pain began to subside. One Sunday, the patch fell off my skin, I did not know until then that a patch retainer film could be worn to keep the patch in place. Until the effects of the new patch kicked in, I was in such pain I began to laugh almost into delirium, but that produced endorphins to ease the pain. My friend thought I was going crazy, but I knew what I was doing.
Coming off pain killers
The pain of cancer is in another realm, it cannot be explained, the therapy for chronic pain has addictive qualities too. When the pain had gone, I could not just take off the patch, I had to wean myself off it, this is where the mind and the will come to play. Addiction has much of its roots in the psyche first than in its palliative effects. The palliative which is in itself a kind of comfort has to be consciously managed.
In my case, it took another 2 months to come completely off the patch and other pain medication. With the patch, I cut it in half and left it on for longer, each patch dosage halved and left on for much longer until my body could do without the drug.
Then, we all have innate tendencies to addiction and some people might be able to avoid addiction. There was another instance where a change in drug regimen meant I could not sleep, the first suggestion was to put me on sleeping medication, however, I thought of working a plan to take my pills at a certain time and avoid completely drug-induced sleep. I could see the dangers of becoming dependent on sleeping pills.
Addiction is first personal
Going back to the purpose of writing this blog, addiction has social, emotional, economic, relationship and physical consequences. In my view, addiction is not just to drugs or the abuse of drugs, alcohol, it could be sex, it could be religion or any other activity. The person and people around that person suffer, and that is very sad.
Regardless of what brought on the addiction, it is always first a personal struggle, what other factors contribute to it does not take away from how the person might have succumbed to addiction. Whether we fail to be better informed of the debilitating side-effects of a drug does not take away from the balance between efficacy and damage.
Apportion rightly
The science would suggest a drug can do something, most drugs have to recoup research and development costs and it unfortunate that some people put the profit motive well and above the welfare of patients and customers – that is commerce, we cannot avoid it.
It is, however, a long stretch to conflate personal tragedy, addiction, the science and the commerce into one clickable title of Opioids, My Mom's Death, and Why People Trust Science Less and draw the conclusions in the piece without properly assuming personal responsibility on the one hand and understanding that every individual has a unique physiology that adapts to medication in different ways which could influence the mind too.
I recall my doctor saying they could treat my condition but it depended on my physiology to tolerate the medical regimen. I lost a friend to a similar condition because his physiology did not have the capacity to tolerate the regimen of chemotherapy.
The responsibility of addiction remains a personal thing, the responsibility for being properly informed lies within the person, their medical support, the pharmaceutical companies and the science that balances efficacy with possible side-effects, with the hope that efficacy outweighs side-effects.
I am sorry, the writer lost his mother to addiction, but if we are to trust science less because of the conflicts of interest between treatment and commerce, we would all die sooner in more misery and pain with respite or comfort. That is why these issues need to be treated completely separately even if they are linked in a personal tragedy.


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