Pills and the Pain Management Culture

Anyone who follows this blog avidly knows that I work in the medical field and often enjoying learning new things, whether on or off the clock. While lying around on this couch this morning, I did what I always do – go channel surfing after getting sick of watching the ESPN anchors recap the latest culturally insensitive comments by a high-profile athlete ad nauseam.

What caught my eye this morning – and the inspiration of today’s entry – was a special on Discovery Fit & Health on Bipolar Disorder. The special chronicles families raising children who are bipolar, including a grandmother who was raise FOUR (!) kids ages 14,16,17, 19 (2 boys and 2 girls) who were diagnosed at a very young age. As I watched the special, I found myself nodding and giving all the caregivers kudos for being as strong as they were in caring for these special young people.

The most poignant moments for me came from the grandmother who was gracious enough to share her fears and anxiety over her grandchildren’s future, along with her routine of reaching into a “medicine bucket (!)” where she pulled out long strips of pill containers, each marked for the kids and time in the day for meds to be taken – am vs pm.

Stories like these underscore the fine balance that the underlying drug culture has here in the US. When we first think of drugs it is always the illicit chemicals that grab the headlines, along with some of the legal ones that get abused – crack, heroin, methadone, Oxycontin, alcohol, marijuana most notably. However, there are a lot more drugs out often being used to battle things such as ADHD, autism, bipolar, manic depression – and these are just some of the headliner BEHAVIORAL drugs that kick up strong feelings for and against their use and possible abuse/over-reliance. Pain management, both mental and physical, via drugs is as much a part of Americana as apple pie, cookouts, being a rebel, and Southern Hospitality.

Patients and families always have to make difficult choices. People on the one hand understand that when used correctly, many of these drugs can make a difference to improve functioning. On the other hand, there is the struggle against the undertow of solely relying on the meds to do the work to provide balance. Striking that right balance takes trial and error, often the right mix of meds, attitude and behavioral changes that constantly need to get adjusted.

Watching the special had me think back to one of the story of a dear friend who I was able to see yesterday for the first time in 10 years. She has been making incredible strides on her ongoing journey of being diagnosed with social anxiety disorder and ADHD as a child. I joked with her yesterday saying that even 10 years ago if some one had told her she would get to a point where she was comfortable enough to wear a summer dress in a bold print, she would have chased them away in disbelief. Now, she is medication free, has lived in France, traveled to New York and works at one of the main airports in Jamaica. Just seeing her yesterday amongst her group of friends was pretty special – she was just “one of the girls”. The sky’s the limit for her, and she has embraced those possibilities fully.

Pain management when medication is involved is such a case by case situation. Many folks who have to have medication in their live only want support and understanding – many would choose to go without the meds if they didn’t need them at the time. People can often be cruel – sometimes more than prayer or willpower is needed to overcome an affliction. Sometimes people are too busy venting off their own problems to see the needs of others. Yet, folks facing afflictions are never these evil monsters that we sometimes stigmatize them to be. There are a lot more people using pills, caffeine and other drugs to handle their afflictions and yet are as functional and on top of their game – to the point I may choose to trust in their management than some other affliction free folks.

While things have improved, I can only hope we get to a point where culturally it is more about being supportive and understanding of using all treatment options to address our afflictions than knee jerk reactions to the stigmas associated with each affliction.

Heaven knows that managing what comes with the affliction daily is stressful enough.



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