I wish to once again express my sincere thanks to those persons and intuitions that have made these articles possible including the Guyana Chronicle specifically the editorial and IT staff R.Johnson, D.Francis and other individuals who have reviewed and provided editorial support in ensuring the publication of these articles. I also wish to thank the readers for their feedback which provided me with the new ideas to write on.

I’ve written about this issue and, more importantly, about the attendant dependence I’ve developed on the painkillers used for treatment about twice over the past two years. In the first article, I wrote generally on the issue of pain management, and the second article had more to do with my reaction to the rife and completely inaccurate speculation of my hospitalisation last year.

This time, I wish to write more directly on the issue, not just the larger picture, but bringing as well some of the unique perspectives that I possess.

Dependency addiction, in the larger connotation of the term, has almost as many manifestations as there are things people can do.
Some people are addicted to gambling, others are addicted to sex. I remember reading one news story a few years ago — I showed it to my son as a hint — in which a young man was so addicted to a videogame that he played it several days non-stop before collapsing and dying in front of his computer. Some people are addicted to shopping, although admittedly (and I expect some repercussions from my wife for saying this) it’s hard to tell if many women are actually addicted to shopping or if it’s just a regular weekend.

That said, chemical addiction, or substance dependency, constitutes some of the most widespread and critical forms of addiction. According to a recent report by Dr. Sanjay Gupta, which I saw on CNN, there are some 23 million Americans currently addicted to one substance or the other – alcohol, marijuana, tobacco, illegal drugs, prescription medication, even glue. The actual order of primacy of abuse, the top three addictive drugs, are, in descending order: alcohol; marijuana; and prescription painkillers; the latter accounting for 1.9 million of those addicts.

I’ve had two major back surgeries in my life – intended to relieve the chronic back pain I experience – and each necessitated the use of very strong prescription painkillers for my recovery. And I, quite frankly, have struggled with a clear addiction to them.

There is a serious and sad irony attached to the use of powerful painkillers: while they work well to relieve pain at the onset, very often, with the real pain gone, the body (or brain, rather) becomes so addicted to their effects that coming off them makes the patient feel much worse than the pain they helped to relieve in the first place. Coming off a strong prescription painkiller is a living, waking nightmare of craving for the drug, body chills, insomnia, anxiety attacks, depression – one minute you’re ecstatic, the other you’re irritable and no one can talk to you. All these are things I’ve experienced, and it is no picnic for me.

The thing is it isn’t a picnic for others either, as, with any addiction — particularly chemical ones — the addict doesn’t suffer in isolation. The drugs alter the addict’s personality so subtly but so significantly at the same time that although the addict most likely won’t notice the difference, the worst of it – the alienation, the irritability, the lack of communication – is felt by those closest to the addict.

I’ve spent a long time thinking hard on how this thing has impacted upon my life, and I can tell you that time has been personally enlightening for me with regard to my perspective on substance dependency. For example, you see the typical drug addict, the typical junkie, walking on the street and your view of that person is that he/she is somehow subhuman. To satisfy his or her addiction, the cocaine or marijuana addict’s life is one of great personal compromise – humiliating and arduous manual labour for little compensation; being treated with indignity and scorn by almost everyone they come across. I’ve been witness to one ‘junkie’ disparaging another – equally ragged, equally homeless – because the former would only smoke marijuana and drink rum, while the latter was a full blown cocaine addict.

At a fundamental level, prescription pain medication dependency is the same thing, the same sacrificing of personal standards, granted to a much lesser degree. This sort of medication is difficult to come by, and while I’ve personally never checked, I am sure that it is far easier to get a joint of marijuana or a gramme of cocaine than it is to procure, say, a couple of Vicodin tablets, or a syringe of some other pain-relief drug.

If I’m to be honest with myself, at my worst point of dependency, I’d say I was nothing more than a sophisticated junkie; and like any junkie, my addiction affected how I worked. I’ve been short with staff, and I’ve had to cancel meetings, and the only thing that has spared me really is that my other addiction, work itself, served as a sort of therapy for me.

Potentially addictive painkillers, or potentially addictive regimens of painkiller treatment, should really be the last resort in the treatment of any pain-related condition or illness; and whenever the decision is taken, it should include comprehensive patient education about the pros and cons, in addition to extensive psychotherapy throughout the duration of the treatment. This would save the patient a great deal of pain in the long term, whether actual pain or the psychic trauma that comes with dependency and the attendant stigma attached to it.

Which brings me to this: in an upcoming article, I want to deal frontally with a serious related issue that pertains to patient confidentiality, particularly within the private health care industry in Guyana. While I am grateful to, and have tremendous respect for, the medical personnel that have attended to me at various times, I believe that there are gaps in the private health care system here which facilitate the leakage of an individual’s personal health information, the sort of gaps that would be prosecutable in other jurisdictions.

In closing, let me say that I am extremely grateful that I have the family that I have, and the staff that work close to me — people who’ve weathered the storm of my shift in moods, and stuck by and supported me throughout. I remember going to former President Bharrat Jagdeo and Head of the Presidential Secretariat, Dr. Roger Luncheon, both of whom I had to communicate directly with as regards my professional responsibilities in various capacities, and being encouraged to take as much time as I want to deal adequately with my medical problems. I remember the President saying clearly and sincerely, “We want you to get better.” I, of course, didn’t take their advice, and went back to work as soon as I felt marginally better.

As for my anonymous detractors, particularly those behind the letter-writing campaign that questioned my health, my capacity for job performance, and prompted the article I wrote a year ago, ‘Coming Clean’, about my personal health problems: I will be off for a few weeks, and while I’ve prepared some columns to be published, I apologise in advance that I will not be able to respond directly to feedback for obvious reasons.

(By Keith Burrowes)