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MD @drance
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Please read this article and, if you care to, stay for a story about my personal flirtation with the opioid epidemic after my emergency appendectomy last October.
Some of you may recall I landed in the ER last year with appendicitis, and had my appendix removed. I spent 5-6 hours in the ER while a surgeon became available. I had a morphine drip for some (most?) of that time. But let’s back up a half day to before I went to the ER.
If you’ve had appendicitis, you know it hurts. It’s basically like the worst gas pain you’ve ever had in your life, amplified by… a lot. That morning, that’s all I thought it was. I thought I’d just walk/fart it off, but man this really hurts and I wonder if something is wrong.
It progressively got worse and worse to a point where I thought I might not be able to handle it anymore. I tried to sleep it off, but I couldn’t fall asleep because pain. I told my family to go to our planned lunch without me, because I’d be no fun.
While my family was gone, I started to get sleepy. Very quickly. What had momentarily been relief quickly became “Hmm… maybe it’s not good that I’m, uh, quickly losing consciousness when I couldn’t all day.”

More or less at that moment, my family came home and there were gasps.
Right, so ER, morphine, surgery. In recovery, they informed me that I was doing well and I was on a drip of… another very strong thing. I felt pretty darn great and slept through the night.

I woke up feeling mildly sore, quite tired, but not so bad! And then it got interesting.
The nurse asked a few questions, and then asked if I wanted another dose of the thing that made me high as a kite after surgery.

And then a part of my brain that I did not know existed basically blurted out FRAK YEAH I DO.

Now remember that I was only “mildly sore.”
I stopped myself, and it took what felt like an untapped feat of strength to say “you know what, I think ibuprofen will be fine.”

I was discharged on a Sunday night with an opioid prescription. I asked if there would be trouble filling this on a Sunday night. (Ominous music)
So we head to a drug store, and this is where I need to be careful so as not to get anyone in trouble but… there was a problem with the prescription.

I proceeded to freak out. This is exactly what I was afraid of. I was no longer under care, with medicine for at least a day.
So here is this slumped over skinny guy having a fit on a Sunday night about not getting his bunk opioid prescription filled. Naturally, everyone behind the counter looked at me like I was a junkie.
Long story short, I made some phone calls and got a correct prescription, and found a 24-hour pharmacy that stocked this controlled substance.

While I was standing in line for this (finally)… the exact pain that sent me to the ER in the first place returned.
So that’s nice. Have pain, have surgery, have same pain. I went back to the ER. It was a mild, unserious complication. I went back home and had my pills. Sweet.

The prescription said every four hours as needed. I never took more than two a day. And then I stopped taking them.
Basically right at the 24 hour mark of me stopping the pills, I had:

- My first migraine headache in ten years
- Dramatic loss of energy
- Extreme irritability

I was in withdrawal. For taking less than 50% of the allowed/prescribed dosage on the bottle.
Oh, and my surgery scars still hurt, of course. So ask yourself how many people would not pop another pill in this situation, whether they recognized what was happening to them or not. I sucked it up and decided I was not going to touch those pills again.
Now read this whole thing again and remember that I am a rich white male with good health insurance. Look at that second ER trip and remember this story:

latimes.com/business/hiltz…
I always read about one-dose addiction and thought it couldn’t be true. These people must have something else going on. Then I had that one hit of whateveritwas.

This crisis is real. Even if you think these people are weak, it only underscores the predatory nature of the crisis.
I don’t know what the precise answer is, but I can attest that “tough” tactics and stigmatization will not save true addicts, and it certainly will not help non-addicts who are in actual debilitating pain. No way.
Right on cue. This is not the answer. We need to put things in front of people that will help and educate them, not pretend we can close them off. We will only close them off from society, like these policies always do.

Some footnotes to this story:

I found that chocolate helps with withdrawal. This was later confirmed by a medical professional in the family, but I discovered it on my own by inexplicably eating all of the Halloween candy like an animal.
I debated going here, but since I’ve been asked, no. Smoked and drank on and off as a kid, never hooked on anything. I’ve been prescribed Vicodin more than once and it never impressed me. This stuff rocked me. IV was stronger than the pills, of course.
(Answering an offline question) I ate the trick-or-treat candy we bought, not the candy my kids earned on the street. I’m not Donald Trump Jr. usatoday.com/story/news/pol…
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