Ask Paul at the RSIC: Coming to terms with the opioid crisis
November 26, 2018
Last month we discussed how to say "no" to our friends and family who were involved in substance use and/or negative behaviors. This month we are going to discuss how to help our physicians say "no" especially when it comes to prescribing opioids. First we'll explore the problem, and then we'll look at possible solutions to solve the problem.
The problem is we have an opioid overdose crisis. One reason we have this problem is due to the sheer volume and availability of opioid pain pills like oxycodone. Obviously, when any drug is made more available, more people will use it.
Not long ago, opioids were normalized and made very available. During this normalization process, one of the messages given to physicians was that patients were not supposed to feel any pain. Since the doctor had no way of knowing what level of pain the person had, the doctor would show the patient a line of doodle faces which ranged from a sad face to a happy face and ask the patient to circle the face that correlated to his level of pain.
The goal was to be pain free. Today we realize that pain has a function in our lives. It has helped us survive by avoiding dangerous situations and avoid negative behaviors like putting a hand on a hot stove. Pain is our body's way of communicating with our brain to tell us to discontinue a behavior.
We have an opioid overdose crisis. One reason we have this problem is due to the sheer volume and availability of opioid pain pills like oxycodone.
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The body only has only two states of being pain free and they include being anesthetized (for a surgical procedure) or being dead.
Pain medications can interfere with our senses and can keep us from connecting spiritually with our ancestors. In Wellbriety, we strive for spiritual, emotional, mental and physical health to reach our greatest potential. We want to reach our full potential in all areas of our life to maximize our ability to help ourselves, so that we may be available to help others, especially our youth.
Also, not too long ago, there was a belief that painkillers were not addictive. At this time, we realize that opioids are very addictive and can easily lead to overdose and death. We have the obligation to learn from our previous mistakes to live healthy and happy lives full of family fun, good food and laughter!
Today doctors realize drugs work to cover or mask pain. Actually drug use doesn't always heal the source of the pain and can even cause more pain. The body and brain become reliant on these drugs and as a result discontinue naturally creating these chemicals internally. This is evident with the withdrawal symptoms that people experience when they discontinue their substance use.
The new medical focus is on the patient's quality of life and ability to function, not exclusively on the person's pain. This is where the person can become a partner and not a patient by helping make decisions that are more proactive with less medications.
The new goal is to be using less to no medications, especially as we get older. When the person becomes an active participant in his health care, he is internally motivated in his own health and willing to endure healthy discomfort, knowing his body is healing and the pain is productive. A passive participant expects a pill or solution from an outside source to take care of them.
The Elders did not have an opioid addiction or overdose crisis. What did our Elders do when they felt uncomfortable? Were they ever cold? Did they ever feel tired? What did they do if the wood needed to be chopped and they just didn't feel like it or were tired? If they were hungry, could they order Uber eats and have a burger delivered or did they have to put in effort to obtain food? What if they didn't want to put in the effort?
Notice the difference with how the Elders previously healed and our current society. The Elders used natural remedies and worked with their body allowing themselves time to heal. Today, many people look for complete and quick pain relief in the form of a pill, drink or substance.
If a person breaks his arm, he'll be grouchy, lose some sleep and have a tender arm as it heals. If the doctor gives the person painkillers to help with the pain for a couple weeks, then discontinues the pills, the broken arm will heal, and the person will have used the pain pills as a tool to avoid unnecessary pain. However, if the person is on the same pain pills two years later, long after their arm has healed, there's a problem.
A new approach is to ask the doctor to explain an exit strategy and define what success looks like before the prescription is written. Let the physician know you understand there may be some discomfort, but you are willing to feel uncomfortable for a short time to retain your senses. The physician will appreciate this "team" approach with the partner/patient and empower you as the partner/patient to advocate for your health.
By changing the health care focus to healing the patient's emotional, mental, and physical pain and not just focusing on quick pain relief from a pain killer the patient can receive optimal health care. Keep in mind, the most important person in this team is the partner/patient. Because who cares more about this partner/patient's health than the partner/patient?
The Red Road to Wellbriety teaches us that we want to be as smart as we can be, as fast as we can be, and as healthy as we can be to help others who are not as smart, strong, fast or healthy as we are. Native American warriors strive for individual health, family health and community health. This thought process may be uncomfortable and scary at times. It's OK — you, your family and community are worth the effort. O
"Ask Paul" is a health column by Paul Snyder, MA, LADC-S, a Substance Use Counselor at the Reno-Sparks Tribal Health Center. It publishes each month in The Camp News, the monthly newsletter for the Reno-Sparks Indian Colony community. Have a question for Paul? Email him at firstname.lastname@example.org.