The Bitter Truth About Fighting Chronic Pain Without Opioids

5 Simply Plan Your Entire Life Around The Pain

When I was a kid, I had a diving accident that did permanent damage to my neck and back. The details aren't important -- it really is the kind of thing that could have happened to any sensible person -- but the result was that from ten feet in the air, I landed headfirst on a sandbar that was covered by just a couple of feet of water. I was completely vertical, like a goddamn Tom And Jerry cartoon. It hurt. And I didn't even get the dignity of a wacky *boing!* sound.

As a result, for the last 30 years, I've dealt with chronic back pain. At its worst, it feels like a star collapsed inside my body. Sometimes, though, it changes gears and feels like someone hammered a red-hot nail into my neck and left it there. When that happens, sneezing or coughing will send a lightning bolt up my spine, a jolt of agony that makes me feel like I'm going to piss my pants. That can last for weeks. I've had broken bones that didn't hurt like this. Other times, the muscles will suddenly get so weak that they just turn to Jell-O. Here, try this: Drop to the floor and do crunches until you physically can't anymore, and then keep doing them for several more minutes. The muscle death you feel, coupled with that pulsating burn? That's what I feel on most days, from sunup to sundown.

But I of course can power through it without the help of my painkiller prescription, via the irrepressible power of the human spirit. It just takes a little extra planning if I know I'm going to be doing anything extreme, like being on my feet for a couple of hours. For example, I recently took my daughter to the mall for some birthday shopping. After an hour and a half, I physically couldn't walk anymore. By the time we got back to the car, I thought I was going to have to beg a stranger to help cram me into the driver's seat, urging them to press on through my screams. Had I planned better, I could have simply quadrupled my dose of aspirin and Skyped with my daughter from the car while she shopped.

That's the key to pain management: planning ahead and not doing the thing that causes you pain, and also remembering that nearly all things cause you pain. For instance, I pace when I talk on the phone. I can't help it. This means a 20-minute phone call can potentially seize up my back so completely that I have to execute the sitting process in slow, gentle stages, looking like a GIF loading on a spotty LTE connection.

Of course, if I was smart, I would just stop talking on the phone forever. Or I could plan ahead by taking a few aspirin and toughing through that shit like a tank. I just need to cue up some Jeff Sessions and remember his inspirational words: "But, I mean, a lot of people, you can get through these things."

4 Let Societal Scorn Work Its Magic

Over the past eight years, my wife has been through the following:

-- An injury that resulted in two knee surgeries

-- Her ACL torn right in half, resulting in a third

-- Chronic migraines that regularly send her to the ER

-- Fucking brain surgery

When her ACL popped, she couldn't touch her foot to the floor without crying so hard that she was close to vomiting. After the first doctor visit, they sent her home with two ibuprofen and a pair of crutches. It wasn't until a week later that they did a scan and saw the tear. Between this and her original surgeries, the doctors said she'd likely be in pain for the rest of her life. Yet any time she complains to them about the pain, they look at her like she's trying to bullshit her way into some sweet, sweet drugs. As if she went into the joint and popped that ligament with a pair of bolt cutters just so she'd have the pretense to take an occasional flight on Opioid Airlines.

I get the same. Any time I have to ask for pain medication, it's followed with a suspicious look and "Are you sure the ibuprofen isn't helping?" I understand. Even though I'm just asking for weak-ass Tramadol (a synthetic opioid specifically designed to be less addictive), you can still get hooked on that. I'm aware that addicts fake their way into prescriptions all the time. I also know that they sell them on the streets, and to be perfectly honest, I'd have an easier time buying the pills off of them than getting them from an actual doctor. The doctor is the only one who will judge me as a piece of shit.

Fortunately, feeling like a scumbag addict is a great motivator for staying away from opioids, despite the fact that they do take away 100 percent of my pain and allow me to physically function through an average day. Politicians say you're just weak. Perspective employers see you as a potential pill-popping train wreck. Co-workers and subordinates look at you like you're Dr. House. Friends and family will compare your pain to theirs and blow it off. ("Your back hurts? That's nothing. I lost three fingers working at the guillotine factory. You don't see me suckin' down pain pills") I simply have to measure the physical pain against the psychological/emotional pain and realize that the latter is greater. Problem solved.

3 Trust The Professionals To Let You Know When To Endure Excruciating Pain

The absolute best way to stay away from opioids is to let the medical profession do what it's currently doing: restrict the everloving shit out of them in a completely arbitrary way. For instance, did you know that CVS announced in late 2017 that they would be limiting opioid prescriptions to a seven-day supply? And that patients would have to try the immediate-release pills before switching to the much more effective extended-release pills that chronic pain sufferers need? Thank. God.

Here I was, worried about my own willpower and aspirin-taking toughness, when all I had to do was wait for doctors and pharmacies to step in and say, "We got ya, buddy. We will fucking die before letting you abuse your medication." I wish they'd take it a step further and just have me come in every time I need an individual pill. Just hand it out at the counter with a little cup of water, like Nurse Ratched from One Flew Over The Cuckoo's Nest.

Of course, "seven-day supply" doesn't really have much of a meaning. My wife's 30-day supply of Tramadol is 30 pills. Take a look at the instructions:

Now, if we're talking about someone who has pain once per day during a specific four-hour time span, that is definitely a 30-day supply. But if we're talking about someone who is dealing with chronic pain, then taking the recommended dosage makes that bottle last seven to ten days. And that, my friends, is one hell of an awesome way to beat opioid dependence. Just make them up and vanish for 20 days per month. No more worrying about willpower. No need to toughen up. It's totally out of your hands. "You're out already? Well that sucks. You shouldn't have taken what we told you to take. Oh well. Come back in 20 days, and we'll get you some more. In the meantime, here's some aspirin. How's your toughness?"

2 Don't Worry, Self-Care Is Your Ticket To Complete Opioid Freedom

Have you ever shopped for computer chairs at an office supply store? They always have little tags with a single-digit number on them. If you never looked up what those mean, they're "suggested hours of use." So if the tag says "5," they're saying, "Don't sit in this for more than five hours per day, you lazy, computer-using turd." I routinely work in a computer chair for 18 hours a day. There are no computer chairs with a rating of "18".

In order to prevent my vertebrae from permanently fusing together, I follow the rule of thumb to get up and walk around for five to ten minutes every hour. And that will absolutely work for all of you too, because you also work from home and have no boss who will walk over and say, "Every time I see you, you're walking around aimlessly, doing nothing. Do you want me to fire you?"

Now, if you're one of the rare people who does have a boss (loser), you should just explain to them that experts recommend that you stand for two to four hours during your work day, and you'll either need two desks (one for sitting and one for standing) or a sitting-to-standing desk for your office. Those generally only cost around $400. They should be fine with that.

If you work in physical labor, you'll need to do the opposite, taking plenty of breaks to get off your feet. The great thing about physical labor is that it's a job known for its reasonable, empathetic supervisors and flexible project deadlines. They will have absolutely no problem with you pulling up a chair once every hour for some pain prevention. There is no way they'll say, "I didn't hire you to sit on your ass. Get back to work or allow me to go spend the three minutes it would take me to find a replacement."

1 You Will Definitely Become Tough

Here's the thing about chronic pain: It doesn't just affect you or your throbbing body part. It turns you into a dick, because it's impossible to maintain a positive, healthy state of mind when all you can concentrate on is *throb, throb, throb, throb, throb*. Unless you're showing exaggerated physical signs or you outright tell someone about how much pain you're in, other people have no idea why you're being a douche. They just think, "Man, screw that dude." People in my situation usually know what it's like to ask for a promotion and be interrupted with, "I'd really love to give you the position, but you really are a piece of shit, Chad."

Also, chronic pain is often linked with depression, and the two feed off of each other like the Auryn, only made out of human shit. The pain makes the depression worse, and the depression robs you of the motivation and energy to manage the pain. It's a perpetual motion machine that often ends with goddamn suicide. "How tragic, he was always so sad for some reason." YES, MAYBE IT WAS BECAUSE THE ENTIRE TOP HALF OF MY FUCKING BODY WAS ON FIRE.

The upside is that if you survive a few decades of this, you'll be tough as hell. You could be catapulted anus-first into a cactus made of metal and be like, "Pfft. Just give me a couple of aspirin. I'll be fine." Hell, Jeff Sessions may even put you in one of his speeches.

"I knew a writer who couldn't walk the length of one shopping mall," he'll say. "His pain was so severe that he only slept a few hours per night. It gave him chronic depression. He had been in the hospital multiple times for nervous breakdowns. His kids learned to not ask him to go on long trips, because he couldn't physically handle the car ride. But by God, he didn't take opioids, because that man, he was as tough as a leather dildo."

You can find John and lots of your favorite writers at The Modern Rogue, where he is editor in chief. You can also follow him on Twitter.

And heck, maybe leatherworking could be a fun hobby to take your mind off the pai--nah, not really.

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