So I’m doing a slightly scary thing: attempting to go off my opiate-based painkillers. And it’s making me all philosophical-like.
At the moment I’ve only attempted to go off them at night. Although I haven’t taken any of my big powerful painkillers in the evening for a couple of weeks so far, I woudn’t call it an unqualified success. I have some codeine-based tablets for breakout pain, much lower dose, but I seem to be averaging one dose of those most nights. Which hardly qualifies as ‘going off opiates’. And in spite of that I have still lost quite a lot of sleep.
Most unnervingly, I have been reminded of just how much pain those puppies had been killing. Cer-ikey! Even though I am still taking my morning dose, the much higher pain levels from overnight have been bleeding through into my days.
Waking up in the morning is not good. And I’ve been using my breakout pain relief (heat, TENS, paracetamol, anti-inflammatories) ALL the time. Getting all the run-on effects – vertigo, jaw pain from tooth-grinding, nausea, totally foggy brain making me constantly forget my … thingies. Words. Being very low on spoons.
The temptation to go back on the Big Stuff is very, oh very strong. And I could. I could always say, oh, work is especially busy (which is true), and maybe it’s not the right time just now. I’ve basically been given the go-ahead by my doctors to stop for a while and try again if that’s what I need to do.
But I keep thinking: I went onto these things knowing they were temporary. I knew the risks from the start. I went on them to save my sanity, and to get my pain management ducks lined up.
And they are.
Taking opiate pain relief for chronic pain is a deal with the devil. You can have what you wish for – some kind of relief from grinding, sanity-sapping pain.
But the devil doesn’t do freebies, and you pay up big. You will never get quite as much relief as you’d prayed for. After a while, the drugs start to lose their power and you need more and more to maintain your relief. Keep going, and the meds actually start to cause you more pain. And the devilish little suckers are addictive. And they are not great for your liver, long-term.
So, having made my deal and gone onto the painkillers, I’m left with two choices. Either stay on them and end up addicted to medications that are making me miserable, or go off them and deal with what I now understand is the reality of the matter: life without painkillers is more painful than life with them.
The truth is, there will never be a ‘good time’ to do this. I probably haven’t developed a hard addiction yet so now is as good a time as any.
I guess the main shock is rediscovering my pre-opiate pain levels. They are really no joke.
There is a saying: one definition of insanity is doing the same thing over and over, and expecting different results. So why am I so surprised that stopping painkillers means more pain?
What has changed since I started taking them?
I know more about my conditions
I no longer hope for a cure: I am more able to accept that my life is different
I am on other meds to deal with my other symptoms, which are safer for long-term use
I have strategies in place to help me manage my life, e.g. less hours at work
I am fitter, and continuing to get fitter still
I know more about myself in regard to nutrition: I don’t expect miracle cures through food, I know what suits me and what doesn’t and I have learned to reject ‘miracle diets’ in favour of eating a normal nutritious diet without stressing over it
I am more confident in myself and less anxious (thanks ketamine!)
I have the option of continuing with ketamine infusions to control anxiety and keep my pain triggers turned down a bit
I have strategies and tools in place: mindfulness, counselling, TENS, yoga, hydrotherapy, healthy distractions like my garden.
What hasn’t changed?
My pain levels. Speaking honestly, they don’t appear to have decreased at all.
So, I’ll probably be in as much pain as I was pre-opiates, but I will be a much more confident, less stressed version of what I was before.
Taking this all into account, I honestly can’t see any reason not to ditch the opiates.
The serious challenge will be going off the daytime dose. If nights are so bad, I can’t imagine any way that daytime won’t be utterly ghastly. I sincerely doubt that my lifestyle won’t be adversely affected, at least for while until I get used to it. Perhaps the sensible thing to do would be taking some time off. Possibly I can combine it with my next infusion.
The thing about a deal with the devil is that it always costs more than advertised. Here is where I start forking out.