Wednesday, June 14, 2017

The Real Solution, Part 2: Climbing Everest

In May 2006 I had had a successful surgical intervention with an implanted neurostimulator, but by December of that year things started slowly worsening again--a consequence of this genetic defect within me, this strange variant of Complex Regional Pain Syndrome. I was at a low point in my life--afflicted with constant, severe pain and taking a regimen of Oxycodone and Methadone that was negatively impacting my ability to teach at the level and quality I desired to deliver to my students as they prepared to face their future academic challenges in college.
It was then that I had a hard conversation with my doctor and was willing to make a desperate attempt to save my career. My doctor told me about a medication that worked differently than other opioids. This medication, Buprenorphine, is unique among all other narcotic pain-relievers in existence. It is what doctors call a "partial agonist." There is an excellent graphic that explains the difference in how Buprenorphine works in the body and why it is better than other opioids that you can see by clicking here.
In short, the way Buprenorphine is processed in your body is not unlike how it processes Vitamin C (in the most general sense--it's obviously a very different chemical processed by a completely different system, but the analogy works). You can take tons of it, but your body can only handle so much and it then funnels the rest directly into "waste extraction." In essence, it is extremely difficult to "get high" on Buprenorphine. For me, in terms of the pain relief, we initially took a few months to determine how much of the medication I needed to get equivalent relief, but Buprenorphine is much more powerful than most other opioids despite the fact that it metabolizes so differently than other opioids.
Morphine is the typical standard that is used from which to compare opioids, and even though there is a lot of personal factors associated with metabolism and height and weight that need to be considered, but all things being considered equally, Buprenorphine is considered to be about 40 times more potent than Morphine and Vicodin, and about 400 times more potent than Codeine. There is a very comprehensive chart at this link that shows the relative strengths of pain relieving effects in the body including some synthetic drugs are are only used to sedate large animals.
I have now been taking Buprenorphine for about nine years and it still continues to meet my needs--that is, along with my neurostimulator this medication makes what is considered the most intense pain condition known to medical science tolerable enough for me to maintain a full-time position as an educator teaching physics to college-bound high-school students. To me, this is a miracle drug and has restored my life. While I know that each person's metabolism is different and this may not work for everyone and every kind of pain, you have little to lose and so very much to gain.
I remember feeling an epiphany ...a moment of tremendous clarity when I realized that my personality had changed radically along with the loss of my higher levels of thinking and memory. Once I started exclusively on the Buprenorphine, I felt like I was emerging from a fog and I could see the Sun again after literally months of deprivation. It hasn't been perfect, but it has definitely been worth it and the best decision I have made even above my decision to get the neurostimulator.
However, like the decision made by a few daredevils in this world, I liken this decision to climbing mount Everest because it requires significant mental and physical preparation and building up an endurance to make the long haul of what I believe will be several more decades of my life living in constant moderate to severe levels of pain interspersed with occasions of excruciating pain. I imagine that there are some would willingly die to sooner end the torment not unlike those whose corpses litter the path to Everest's peak. Indulge me a little longer while I describe the pros and cons of making this choice....
Next blog post ("The Real Solution, Part 3: Climbing Back Down the Mountain") will be posted on or around Wednesday, June 21.
Post-script note: For those who are being treated with Buprenorphine for addiction, I think that there is a reason why so many centers that used to use Methadone are making the switch. By interfering less with the higher brain functions, in the same way that I now rely more on my own ability to cope with the pain, those who are truly interested in recovering from addiction will appreciate having the mental strength to do so.
Methadone was once the only real option for heroin addicts wanting to clean up their lives before an overdose ended them, but Methadone--despite being synthetic--is still, itself, highly addictive, and heroin addicts in the past were often only trading on one addiction for another that was only regulated better without necessarily being better. I believe that Buprenorphine holds the same potential for a miracle for addicts as it does for chronic pain victims, and greatly increases the probability that a "former addict" can reclaim much of what was lost of their past and who they were as well as hope for being a positive contributor to society.
I would love to hear from any former addicts who are now taking Buprenorphine, particularly those who once took Methadone, but any experience--even if it does not perfectly validate my position--would be a welcome contribution to this blog.
Post as a comment or email me at if you would prefer to maintain your anonymity, and just write your words in such a way that there is nothing personally identifiable so that I can pass it along without having to paraphrase it.

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