Tale of Two Suicides; Lessons for Opioid Public Policy

When the final choice is ….

http://nationalpainreport.com/tale-of-two-suicides-lessons-for-opioid-public-policy-8828356.html

For one it was the best of times, for the other, the worst. At no time did the paths of their lives cross, but they shared the same fate, one most would consider a tragedy. Their legacies, for pain and public policy, could not have been more different…

 I knew one, only heard of the other; both dramatically affected my life.

Bob was a marine. He had valiantly served his country, and he was proud of it. His identity was so tied to his service that he could not handle the thought of being any less of a marine, a warrior… a man, whatever that means. His back injury robbed him of that identity, and he struggled in a futile attempt to regain that which he no longer was, or, at least thought he was. Perception is reality, and his perception was that he was no longer what he wanted to be, needed to be.

Surgeries and elixers, therapies traditional and non-traditional. All tried in a vain attempt to rid himself his pain. All failed. Some made his pain worse.

He used pain meds to numb the pain, but they couldn’t restore his manhood. In desperation, he kept taking more and more. After a while, he gave up the hope for a cure. He was a broken man, not just physically, but also mentally and spiritually. The meds gradually became a temporary reprieve from his painful reality.

I was his doctor. I never really saw that brave marine. Rather, I saw a broken, staggering man, subservient to the world his pain had created for him. Our goal for any treatment is to improve one’s function. For many, opioids accomplish that. Not for Bob…

I told him that I could no longer prescribe the medication for him as I saw it harming more than helping…

There were no candle-light vigils for Fred [Bob]. He was gone, and quickly forgotten…

Billy’s parents took to the legislature to exact vengeance. While few would ever be driven to action to help Bob, there were many who sought to vindicate Billy. There are few things more motivating than a grieving mother’s wailing, and the legislators were not immune. Soon, laws were being enacted in a vain attempt to “stop the carnage.” In a world fueled more by emotion than reason, the land of “feel-good law,” the law of un-intended consequences reigns supreme. Soon, laws were passed. Addicts still died. Those in pain struggled to find someone with the courage to defy those laws and care…and they died too, but their cries went unheard…

The battle has only started, and it is not just in the legislatures, and not just in my state of New Hampshire. It is also in courtroom. In the chilling wake of a second degree murder conviction for Dr. Hsiu-Ying “Lisa” Tseng, accused of prescribing opioids in the course of her practice that led to the deaths of three patients, I, like many others feel lost and vulnerable…

Under comments:

Jackie
November 23, 2015 at 5:49 pm
Have you wondered if telling Fred you were taking away his medication (his main means of controlling his unrelenting pain) may have in fact been the catalyst for his suicide? As a chronic pain sufferer I know a few sufferers who have done so when no longer able to get the medication they need. It is a very frightening thing to face the kind of pain you know is going to come. My pain is managed by opiates, but my strength fortunately comes from somewhere else.. So it’s never an option I would take, but I certainly understand why others may not want to have to deal with unremitting pain for the rest of their lives.

Shari
November 23, 2015 at 4:34 pm
I have Chiari Malformation and EDS and several other chronic debilitating conditions. I am to the point that I have PTSD because of the treatment I have received due to patient profiling and being labeled a drug seeker. Because of this I am unable to go to any dr. and would rather die in my home than go to the ER because of severe anxiety just thinking about calling to make an appointment let alone actually go to it. I don’t drive and have been house bound since August ’14 and spend most of my days in bed or on the couch. That wasn’t the case when I was going to pain management. I actually engaged in life rather than waiting to die like I do now. I’m 43 I do not receive ssdi and live with family because I have a 9 year old daughter and I am unable to properly care for her! Physically or financially. The thought of living another 5 or 10 or 20 years like this is daunting to say the least! But as I hear far too often “it could be worse, at least you’re alive!”
REALLY??? I fail to see how that would be worse!