Have you ever read the novel by Nathaniel Hawthorne called “ The Scarlet Letter? In the book the character Hester Prynne was branded by having to wear the scarlet letter “A”, because it was determined that Miss Prynne was committing the act of adultery. After she was accused, she was sent to jail to await her faith.
Turns out the that the was pregnant and eventually had a daughter Pearl, while awaiting her death. When the day came where she went to the gallows, Hester and Pearl walked down the street to show the village she was not ashamed of her daughter.
The novel’s setting was in the 1700’s and two hundred years later, those with diseases, disorders and injuries suffer a similar fate, though not wearing a Scarlet “A” on their clothing, they endure an invisible Scarlet “O”.
Chronic pain patients who must take opiates suffer with an invisible Scarlet “O” not by choice, just as Hester wore her Scarlet “A” without choice, but do so because of moral and ethical judgements made by others and in both cases it is a social badge of shame which they cannot escape.
Today, especially through the eyes of government and public health, if someone takes Opioids, they are suspect and branded as someone with an addiction or Opioid Use Disorder. According to the FDA, those who takes pain medication per a doctors direction, should not be automatically perceived as having opioid use disorders. Those who have taken pain medication for years, known as legacy patients, have a tolerance to such medications, but tolerance alone is not enough of a criteria for labeling someone as addicted. The definition of addiction requires physical tolerance, obsessive and compulsive behavior centered around acquiring the drug of choice, loss of normal social skills, relationships with friends and family, loss of employment as well as physical withdrawal symptoms when the drug is absent.
The default assumption today, with Government and Citizens alike, is one of automatically assuming addiction or abuse because Opioid are used and that those who use them have caused this crisis. This is far from the truth. And why? Because since 2010, the number of opiate prescriptions consumed has continued to decline, yet the number of overdose deaths from opiates continues to rise. The CDC issued guidelines in 2016 specifically for General Practitioners and ER doctors? Yet all doctors, including Pain Management Doctors and other Physicians like them ran with this narrative.
Sometime after 2010 the CDC under then Chief Thomas Frieden, hired a group called PROP; Physicians for Responsible Opioid Prescribing. The group used weak and inconclusive scientific data, which have widely been criticized as “Doctoring the Books”. Studies which they inappropriately used to show that prescription opioids were the problem in America and the cause for all the overdose deaths. Again wrong! The real cause for the majority of overdose deaths has been illicit opiates such as Fentanyl shipped from China, South American Countries and Heroin.
The DEA, who is supposed to curb illegal drug trade, expanded its mandate going after doctors, pharmacies and even some patients. I believe this was the plan from the beginning. Instead of stopping the illegal drugs from those countries, the dealers, the traffickers, and the King Lords, the DEA went after Doctors, Pharmacies, and some patients, because most don’t fight back, making them an easy mark for the federal government.
Since then the Scarlet “O” has been placed upon us to wear, as if we had a shameful epidemic. Since 2016 chronic pain patients are being turned away from family doctors, psychiatrist and surgeons, because they use pain medication.
Now with caps and limits set for acute pain, the next time you have a fall, an accident, wake up with a disease, disorder, syndrome, and/or cancer, you will then become branded with the letter “O” because you use an opiate to control your pain. More fallout from the 2016 CDC Guidelines include most ER’s will not prescribe pain medication, telling people to instead to use an aspirin, tylenol, or ibuprofen for broken bones, migraines, or any other painful condition. Only if the pain is so severe that there’s no other choice, will they give you a small amount for the least number of days. Then you will be branded with the rest of the 57 million people pain medication.
We, like Hester Prynne, shamed with a Scarlet “O” through no choice of our own, publically railed, taunted by those who are not sick, disabled or who just don’t care, we are being punished for a crisis we did not commit.
The chronic pain community is dying, not from taking illegal drugs, but by being forced off of FDA approved medications for our ailments. Forced tapered or terminated without consent, neglected by biased doctor who believe we will die because we taking pain medications, this is the new norm.
Like Hester Prynne, I will walk down the street, not with a baby, but with my pain medications, and dare one person to spend one second of the day in my shoes, suffering from what I suffer with, a disease that causes my muscles to break my bones. And the pain from job related accidents. To be raped, left for dead, cut and stabbed, needing 475 stitches, and through will and determination alone, I have survived, a broken neck and broken back from two vehicular accidents. A motorcycle wreck that left me with a TBI. I promise you and anyone else that they would be glad to wear that Scarlet Letter “O” if they had to live with what i live with.