We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
There are mayny sources of pain for which opiates are the best temporary fix. For example, knee replacement.
The number of such patients who become addicted is tiny. What bothers me is the withholding of opiates for cancer patients, especially terminal patients with pain. Since cancer is the end of the road for roughly half of people (and increasing as other causes of final ends are being better treated), withholding pain control for the terminal out of fear of addiction seems deeply wrong to me.
Our society sometimes seems crazy in its lack of capacity for regulating complex issues with nuance. Obviously we have a huge modern problem in this country with opiate addiction, but we over simplify handling of the problem. I'm certainly no expert, but it seems to me the vast majority of people with chronic pain seem capable of managing their medicines. I know of one church member who suffers from chronic debilitating pain, and his doctors have been weening him off of his meds solely because of the newly-concocted regulatory obstacles that are in place to prevent abuse. One way of preventing abuse is to stop all instances of the drug being used for any reason whatsoever, is apparently the approach.
I watched my M.I.L. die slowly from COPD. Near the end, the morphine drip alleviated her suffering and mitigated her fears (she was very afraid of dying), and allowed her to still interact with family, kids and grandkids. Removing this treatment option from a terminal patient, because of misplaced societal concerns, would have been (and is) cruel and unusual punishment for a dying person.
My mother took a long time to die, actually set the hospice's record for living under their care. During this excruciating time they told us they couldn't give her more pain meds so she wouldn't become addicted. I hope things have changed since the 1990's as she suffered way too long.
when my dad was dying from pancreatic cancer the head doctor at the cancer department in the hospital said he did not want to give my father a larger dose of morphine as he might get addicted. my brother and I are big guys and we had the strongest urge to push him out the window. he never did figure out why we looked at him that way. another doctor gave my father enough drug to ease his pain. some doctors are completely clueless.
My father was diagnosed with terminal lung cancer. In addition, the tumor had wrapped itself around his spine, which probably caused some pain. When the physicians sent him home after the initial diagnosis, they gave him only a strong aspirin for a painkiller.
My mother got back to the physicians ASAP. The reason they gave her for not giving a stronger painkiller was- you guessed it- they didn't want my father to get addicted to painkillers. My mother called the physicians on their poor reasoning- my father was terminal. The physicians conceded their error, and for my father's remaining three months of life, he got strong enough medication to remain pain-free. This was in the 1980s.
English hospices use creative coctails of drugs to leave their patients pain free. Twenty or thirty years ago they discovered, compiling the experiences of the rare patient that went into remission, that they had not a single addict. When drugs meet the pain that is analgesic. When drugs exceed pain that is euphoric, and addictive. Not that we care in the terminal stage.