Pain

Stephen King, as a result of a hit and run accident, became something of an expert, on a personal and experiential level, on pain. In his fine novel, Duma Key, the main character goes through rehab from a horrible accident and points out that pain is the most powerful dictator on Earth. As I have pointed out a few times, I have issues,, big issues with chronic pain.
Pain, chronic pain, rules your life.When it strikes, and it does so almost whimsically, the rest of your life stios. Ohm you keep functioning, usuallt, but you are never fully present, Part of you, a big part, is taken by the pain. Do not give me that mind over matter nonsense. Do not tell me that you have to be string enough to ignore it. I used to say those things and I was an idiot. You can learn to tolerate pain, to work around it, but pain, when it hits, cannot be ignored or simply pushed aside, not for long. In an emergency, yes, for a very short time, then it is back with a vengeance.
Even when the pain is dormant, it rules you. You are thrilled that you don'y hurt, but you know it will be back and a part of you is wondering when that will be. A sneeze, a slight slip, a quick turn of the head and there it is. Psychologically, it preys on you. You begin thinking that the whole mess is your fault, that there is a punishment factor involved. This is a feature for those of us raised inn the remnants of the old fashioned fire and brimstone Protestantism. It takes a while to get past that one.
What can be done? Damned if I know. There are drugs that help for short periods, As we all know, they have some very nasty consequences if you do not handle them correctly, but they work. One reason I am writing this post is because of the uproar over opiate abuse. There is almost am attitude developing a moral attitude about addiction, a feeling that the addict is weak. morally, and this is wrong. Often, opiate addicts started by trying to deal with very real physical pain. Likewise, many self medicate with alcohol.
We must not make addiction a moral issue. At the same time, we need to find a way to deal with chronic pain. There may be some possibilities with marijuana and, blessedly, those are now being explored. There is also, out on the fringes of research, some evidence that tiny doses of LSD like drugs may have considerable value.
Or, maybe we just have to accept a certain level of controlled addiction. You cannot simply tell sufferers to live with it. That is not going to happen, nor should it. We are often, in these cases dealing with the elderly, the very young and potentially terminal patients and we mist never grow so Puritanical about drugs that we refuse pain relief. There will always be those who simply abuse the drugs because they like them, but that should not lead us to the denial of useful medicines to those who need them, Again, we may have to accept a certain level of controlled addiction, but I am afraid that, in our current political clinate, such reasoned response may be out of the question.
I have nothing left to say ob the matter, no magic answers, no pep talks, no sermons. All any of us can do is use our heads and ise compassion. I truly hope that no one out there suffers chronic pain, but that is a foolish wish. Many of you will and I hope that others understand. Bless all of you

America and Drugs - Opiates

The recent death of Prince and a rash of overdoses in the NE have brought opiate addiction to the foreground again. I say again because this is a periodic plague in this country. In the 1940s, heroin was a big problem but, to be very blunt, not many people cared because it mostly affected the black ghettos. Sorry, but we were even more racist then than now.

Heroin made a big comeback in the 70s. It was cheap and a lot of folks I knew were trying to come down from the hangover left by the acid days. That was a bad plan. Now, we are swamped with high quality heroin from Afghanistan. Odd, the Taliban had stopped opium growing, then, when we invaded they started again to finance the war. Even more odd is the fact that some of our allies there are opium smugglers and now we have a glut of junk. Of course, I am being sarcastic. The American CIA has a long history of drug smuggling, from Vietnam to Columbia and now to Afghanistan.

The timing is obvious. The pharmaceutical companies flooded the market with Oxycodone, which was said to be non-addictive. Of course, it turned out to be horribly addictive, supplies got cut off as doctors put away their prescription pads, and folks everywhere discovered that they had to feed the monkey on their back. And, right on time, cheap heroin shows up and suddenly you have Moms and Dads, even Grandmas and Grandpas, nice middle class folks, out scoring smack.

But, that aside, what of the drugs? Well, they have medical use. They are the only really effective pain killers. Anti-inflammatories work by easing inflammation which, to a degree, eases pain. Opiates kill pain. And that is the problem. They work better than anything else and they are highly addictive. For those suffering chronic pain, I empathize, having been through bouts of that myself. I have no answers except to say, avoid opiates as much as possible. Sorry, that's not much help, but it's  all I have.

Then there are 'recreational users' although what's so much fun about sleeping is beyond me. That is really all you do when high on opiates, doze. However, there is a less obvious effect, well 2 really. One, seldom mentioned is the rush of warm pleasure that flood the body when the drug hits. It really is an amazing rush and it is over quickly, so, using for that reason is idiotic. Then, after the rush, you feel wonderful in an odd way. When you are awake enough to notice, you feel like you are in a warm, little cocoon. safe and completely unattached to the world and its woes. You are completely at ease and I understand the attraction of that, but, again, the feeling is short lived.

Opiates come in many forms, but there are 3 basics. First, opium; usually smoked, not easy to get, and relatively mild. Second, codeine, one component of opium; I never found it to be that great as a pain killer, but, short of terminal illness, it's about all a doctor will give you. It always made me cranky and constipated (a side effect of all opiates). Third, morphine and its derivatives; the other component of opium, it is vastly superior to codeine as an analgesic and much more pleasurable. All 3 have this in common, they are powerfully addictive and withdrawal is nightmarish. I have been with friends who were withdrawing and it is brutal. They all agree that if you imagine the worse case of flu you ever had and multiply by about 10, that is what withdrawal is like.

If you have to take opiates for any medical reason, be very careful. Keep the doses minimal and get off the drug as soon as you can. If you take opiates recreationally, you are an utter fool and you need to get yourself into rehab ASAP.

America and Drugs, Some Facts and Thoughts

For more than 40 years, going back to Nixon, America has been fighting a so called War on Drugs, and losing. We have spent an amazing amount of money on law enforcement and treatment centers and we have a bigger problem that ever. One would think that one of our leaders would say, "Hey, we need a new approach," but, alas, no. Instead, they wring their hands and bemoan the problem and promise action and then continue doing the same things. Such madness must stop.

I am going to write a series on drugs and try to tell you folks the truth about them. You see, much of what we have been taught about these chemicals is nonsense. I am not anti-drug, but I am against ridiculously harmful drugs and I am against the mis-use of any drug. I have a bit, well okay, a lot of experience with these various substances, some personal and some from dealing with the problems of my friends and families.

First. let's be honest. We all, with only a very few exceptions, use drugs. Just today, I have consumed nicotine, caffeine, naproxen, pseudoephedrine, and soon will have a little alcohol, and trust me, many, many folks will have similar patterns of consumption and we would not be considered to be drug users by most people because we do not consume illegal drugs. Yet, if I upped my consumption of those chemicals by just a little bit, I could catch a fairly good buzz. We all use drugs, we just have to use them wisely and we cannot do that until we learn about them.

Over the next few posts, I will cover, depressants, stimulants, inhalants, delirients, tranquilizers, opiates, and hallucinogens. I will also touch on drugs used by psychiatrists and give special attention to two drugs that are hard to classify, alcohol and marijuana.

I hope you will read this series because it is important that we develop a realistic approach to drug use. These chemicals should not be irrationally feared nor should they be taken haphazardly and, of course, many of them should never be touched. One thing for sure, what we are doing is not working.