Tuesday, October 16, 2007

The Stigma against Morphine and Pain Medication

Perhaps this should be posted on my 'Political' page but I feel it is a vital issue that often is ignored by the public and if not ignored, is viewed with attitudes based on total ignorance.

An article in HealthDay News written by a man named Robert Preidt was published on 13 October 2007, decades after it should have been written and published to the world.

The fundamental declaration in this article is that moderate, long-term use of opiate pain medications such as morphine do NOT impair driving ability, but more importantly, according to an expert anesthesiologist, the conclusions of the study indicate that patients on long-term pain medication may be able to live 'like normal functioning people, without the STIGMA and LIMITATIONS now associated with long-term pain medication use.'

The study was conducted by a team at the Rush University Medical Centre in Chicago, comparing two groups of subjects. One group consisted of 51 long-term users of oral morphine. The other consisted of 49 individuals who did not take any pain medication. All the participants spent 12 minutes in a driving simulator that measured deviation from the centre of the road, weaving, number of accidents and the reaction time to unexpected events.

The average weaving for both groups was 3.83 feet and the morphine pain medication group had 5.33 collisions compared to 5.04 collisions for the 'control' group. The average reaction time for the group taking morphine was 0.67 seconds, better than the 0.69 seconds for the control group.

As any idiot should be able to judge without too much trouble, the findings 'suggested that patients who require long-term pain medication may 'become tolerant' to side effects that could potentially impair function.

The reason that publication of this study may be significant is that opiod pain relievers are accompanied by warning labels that urge patients not to drive or operate heavy machinery while taking the medications. Moreover, drivers under the 'influence' of pain medications are subject to the same laws and penalties as individuals who 'drink and drive' even when the pain medication is prescribed and actually MANDATED by a physician.

The prejudice and bias against opiate pain medications is reflected not only in the law enforcement responses to patients but in society's attitudes about 'drugs'.

In point of fact, at least a decade ago, a study was made with respect to another pain medication that is used in treatment for opiate addiction. Although the medication known as 'methadone' is used to treat heroin addiction, it is a very useful pain medication as well, and there are many cancer patients who are prescribed this medication. The study involved a number of individuals who had been prescribed methadone either for addiction or for pain, some of whom had jobs that involved the operation of heavy machinery. The methadone patients had a better safety record than the 'control group' in THAT study. Nonetheless, many employers require random drug testing and either will not hire or will dismiss summarily any individual who is using 'heavy' pain medications, whatever the condition for which it has been prescribed.

This bias against individuals who live impossible lives in the first place, who struggle relentlessly against conditions that severely impair their ENJOYMENT and PARTICIPATION in the ordinary pleasures of life as well as normal activities is outrageous. In the past, too many people who were prescribed strong opiates for medical reasons were unwilling to speak out for fear of society's condemnation. As in any case of blatant injustice and pernicious ignorance, however, education is long overdue.

One need only conduct a 'search' on the internet to see the wildly prejudicial accounts related to morphine and other opiates. One 'educational' site purports to give an 'Introduction' to morphine in the following terms:

'Narcotic agents are potent analgesics which are effective for the relief of severe pain. Analgesics are selective central nervous system depressants used to relieve pain. The term analgesic means 'without pain'. Even in therapeutic doses, narcotic analgesics can cause respiratory depression, nausea, and drowsiness. Long term administration produces tolerance, psychic, and physical dependence called addiction.'

The first lacuna here is the bare statement that 'analgesic' means 'without pain'. For any one who has experienced severe or chronic pain, the term 'pain-killer' is a misnomer. No medication 'kills' severe pain unless it actually can make the patient unconscious. Even when unconscious, the patient may REACT to the pain, moaning or thrashing about a little. The pain is NOT 'killed' by any means. Recreational users of drugs may experience 'euphoria' when 'under the influence' of opiates, but an individual who actually lives with severe or chronic pain never knows THAT state of being. The best that any opiate can do is to mitigate the pain somewhat, to make it controllable rather than insupportable.

The second lacuna here is the lack of mention for the REASON why opiates are administered. 'Addiction' is the bete noir of our contemporary society, the word that instantly summons every negative response. In fact, if a person is forced to exist in a physical state of agony that almost prohibits ordinary life, what on earth is the relevance of 'addiction' to a medication that actually might be able to restore SOME normalcy to the individual's life?

Fortunately, there are other sites that display less prejudice. I found one with a banner that declared: 'Morphine does not kill patients. Morphine kills pain.'
Even if that is not entirely true, even if there is no hope of actually putting pain to death, exorcising it once and for all from a person's life, it nonetheless represents a political step towards objective reason.

I do not wish even to touch upon the subject of 'mercy killing' in this post but suffice it to say that I have been forced to watch some one die without any pain medication and watched others who were being given morphine die as well. Death is a difficult 'rite of passage' in any event, but the sort of individual who presumes to dictate what measure of suffering should be imposed on another in those circumstances should be hanged, drawn and quartered. Life is NOT the ultimate gift. Death sometimes can be a greater mercy and the greater RIGHT to respect.

One final note: It is bad enough not to be able to feel that one is free to drive or engage in ordinary physical activities simply because one is forced to take medications on a regular basis. If people only realised that the worst element in the equation and the graver danger to the safety of others (and oneself) is the actual PAIN or medical condition that mandates the prescription, perhaps they would be a little more willing to understand the need to be able to do whatever is necessary to approximate a normal life.

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