Fentanyl Appearing for Pain, Pills, and Policy

Within the depths of pain

In some ways, I probably have a very high pain threshold, but in late 2009, my pain tolerance was completely overwhelmed when I had cancer in my left foot, with fungating tumours and blackened skin lesions, both deadly and deathly.

Standard painkillers (paracetamol) and stronger medication (tramadol) failed to relieve the pain. It was so intense that I could not put my foot down without crying. In the hospital, I was given morphine, but that only lasted two days before I was vomiting everything.

The Search for Effective Pain Relief

Then came OxyContin, but I was not given enough of it. The nurses seemed to be rationing it even as I begged for relief. However, when I was discharged after 18 nights in the hospital, my pain medication was adjusted. Multiple types of pain relief were administered to target different aspects of the pain.

Paracetamol, oxycodone, and a fentanyl transdermal patch; all that, and pain still persisted, sometimes taking centre stage. I resorted to almost hysterical laughter to release endorphins as a form of palliative coping.

After another consultation, I told the doctor I was still experiencing pain. In his view, my medication should have been sufficient; it was not. He doubled the dose of the fentanyl patch, and only then did I achieve what might be called pain relief.

The Path to Recovery

I was on pain medication from late September 2009, and by the end of January 2010, the tumours were gone. I had fresh, pink skin on the soles of my feet, a miracle of medicine, but it involved gruelling treatment, including chemotherapy and its dreadful side effects.

The pain had gone by March, so I removed the fentanyl patch. Big mistake. I salivated excessively, spat out mouthfuls of saliva, and became severely diarrhoeic. I had to reapply the patch. From this, I learned I needed to wean myself off it gradually. I kept it on for twice as long while gradually reducing the dose by halving the patch at each change.

It took three months to fully stop using the patch, long after I no longer needed any sort of pain relief.

Understanding Fentanyl's Role

Without fentanyl for this level of pain, life would have been unbearable, almost not worth living. One day, the patch fell off. Not knowing you could cover it with a transdermal sticker or plaster to keep it in place until the new patch was ready, I was laughing deliriously. My friend thought I had lost my mind; it was a protective mechanism. If I hadn’t been laughing, I might have been dying from unbearable pain.

Today, fentanyl should only be taken under medical supervision. I also understand that not everyone has experienced the severe pain I did, nor have suffered the otherworldly pain others endure; my pain was eventually brought under control, subsided, and disappeared entirely. I consider myself extremely fortunate.

My body became so accustomed to fentanyl that I couldn’t simply stop using it. It took willpower and determination; perhaps a rare gift. We all have different physiological responses. I am not seeking praise for that.

A Broader Perspective

Beyond the need for medication for chronic pain, there are issues of susceptibility to addiction, both requiring a sensible, empathetic approach under medical guidance across a broad spectrum of related conditions.

Regarding fentanyl as a narcotic, I feel ambivalent. People don’t become addicts solely by enjoying sweets; there are complex circumstances that I believe cannot be addressed purely through criminal justice.

Labelling fentanyl as a weapon of mass destruction would be narrow-minded and lacking understanding of human suffering, especially in pain management.

Learning from Recent Experience

My perspective is personal. I am cautious with medications, aware of their addiction potential. Recently, I used codeine, which converts to morphine in the body, to manage penile and urethral pain during the fourth week of radiotherapy for prostate cancer.

Prescribed to be taken up to four times daily, I rarely exceeded two tablets a day. After three days, I only took one tablet at night. I still felt pain and discomfort, but consciously avoided the lengthy process of weaning off codeine once my body adjusted.

As long as those who truly need such pain management are not disadvantaged by misguided policies, I hope this decision by the White House does not, in pursuit of an ideal, create suffering for many who simply seek relief.

Pain in my blogs

Blog - In hospital to kill the pain

Blog - Getting off the pain train

Blog - Generally responsive and dealing with pain

Blog - Stronger medicine and another course of chemo

Blog - Boldly tell your doctor everything

Blog - Off and back on the pain patch

Blog - Opinion: Where addiction and tragedy can confuse issues

Blog - Knowing pain is personal