Opioids, Pain, Awe, and a Mother's Love
Discussed in this article:
…economic insecurity is associated with more pain. So are discrimination and unhappiness. Pain can lead to depression, causing further pain. “Loneliness strongly predicts the development of pain,” another study found. In effect, chronic pain is tightly woven into the bundle of diseases of despair, and causation probably runs in several directions.
“When people experience an opioid high, they feel warmth, safety and love,” said Steven Chang, an associate professor of neuroscience at Yale. That’s because opioid systems have evolved in part to fuel the good feelings people get from spending time with friends and family, he explained.
A Bit of Awe can Improve your Health
…awe is critical to our well-being — just like joy, contentment and love. His research suggests it has tremendous health benefits that include calming down our nervous system and triggering the release of oxytocin, the “love” hormone that promotes trust and bonding.
I’m from a small industrial town in southern Indiana, a very unhappy place of heavy drug use and despair. I got out as fast as I could and spent most of my life in happier places, but returned from time to time to see family and friends. In the year 2000 I dropped by when I was moving from Tucson to New York and everyone was taking opioid painkillers, particularly oxycontin. Doctors were handing them out like candy. I asked my sister what’s up with that oxycontin everyone was talking about and it turned out she had a prescription. She had taken one and didn’t like it so offered them to me. I eventually took one and didn’t like it, so tossed them in a drawer and more or less forgot about them.
Some time passed and, as is not uncommon, the New York Times came to the rescue. I read an article about how druggies in the know cracked open the outer shell of the oxycontin tablets and then snorted or injected the powder inside. So I got out the old mortar and pestle, cracked open a couple and snorted them. That was the best I ever felt in my life. Certainly up there.
In the following weeks I took all of the remaining pills that way. If my memory is correct, they were 20 mg, so I was taking 40 mg at a time, which is a lot. My dominant memory of that experience is one of intense love for my family. A warm feeling would come over me and everything became enveloped in a golden glow. I’d sit there watching my wife and two young children and feel overwhelmed with love for them. Reading the linked article above, Opioids Feel Like Love, I now understand why.
It was the polar opposite when the pills were gone. I felt like all the love and joy had been erased from the world and replaced with crippling despair. Although I had never experienced anything remotely like that, I figured it was just a drug withdrawal thing that wouldn’t last long, and I was right, but had it been permanent, there’s no way I would have wanted to live feeling like that. It was truly that bad. That was after only 28 pills. I knew I would stay as far away from that shit as possible.
Perhaps that’s why I have so much sympathy for the worst kinds of druggies and their hopeless place in society. Social workers will tell you that all of them were abused in some way. They were most likely unwanted pregnancies. If opioids are like a mother’s love, it makes sense that they want some of that. It makes sense that it would be intoxicating and addictive for those who never had a natural supply. It’s unfortunate that the medical establishment, politicians and law enforcement have no clue what to do about it, mostly implementing policies that just keep making it worse.
I am a chronic hiker, both on city streets and out on trails in the country. I’ve always walked far more than anyone else I’ve known and being in New York took that to a truly ridiculous level. Unsurprisingly, considering the distances I walked and the fact that I’ve always been at least a bit overweight, I’d get some foot pain after walking long distances. At one point, I mentioned that to my doctor and he gave me a prescription for oxycodone, which is the powder inside the shell of oxycontin. Considering my experience with the oxycontin a few years back, I was wary of taking them at all, but they were only 5 mg and really did help the foot pain. I remembered the horrible despair I felt when I snorted the large doses of oxycontin and swore I’d never let that happen again, and I never did. I only took them when I went on long walks, and then no more than twice a week, and then in only small, less than prescribed doses.
Fifteen or so years later, I take them still, only now it’s hydrocodone, and roughly the same rules apply. I only take them when I’m doing outdoor exercise that goes beyond what is comfortable, and I never take them more than twice a week. I’ve never become addicted or abused them. They’ve been an unmitigated good thing for my health and mental well being, allowing me to get a lot more outdoor exercise than I otherwise would.
This past year has been very painful. I’ve had two surgeries, severely sprained my knee, and developed neuropathic pain in my leg, what they generally refer to as sciatica, which is by far the worst thing I’ve ever experienced. Throughout all of that, I’ve kept to the rules. Despite the horrible pain, I only take opioids if I’m doing physical activity outdoors, and then no more than twice a week at less than the prescribed dose. The rest of the time I just live with the pain. I’ve gone many long stretches without them with no issues. I just get less exercise.
I was fortunate that I’ve had plenty of love and experienced plenty of awe in my life. I think I was also fortunate that I went way overboard back in 2000 and learned just how easy it was to get addicted to those things and something of how horrible it would be to get addicted. In addition to allowing me to use them responsibly and to my great benefit for so many years, I think that experience gives me some insight into why so many people are set up to suffer so miserably.
The big picture opioid story parallels my own experience, but is not so happy. Doctors handed them out like candy for many years resulting in millions of people getting addicted and suffering tortuous withdrawals, then they went in the opposite direction and refused to prescribe them for responsible people who really needed them, the result being that a lot of people turned to the black market which is now dominated with fake, fentanyl-laced pills. I personally know two people who died from fentanyl. One was what you might call a low-life druggie. No one cares bout those people, other than their kids, eh. Even in death, you can be sure he’ll be a big influence in their lives. And maybe a parent. The other was a nice young college educated professional. Society would have recognized that as a tragedy, but the family kept it quiet. These days, taking black market pain pills, or black market anything, is like playing Russian roulette. That’s not a game I’m going to play, but for a lot of people the risk of death is outweighed by the reality of their pain, be it existential, physical, or more likely both.
When I moved back to southern Indiana a few years ago and asked my doctor for a prescription, he just assumed I was a druggie and essentially said hell no. I understood and didn’t hold it against him. Given the local environment it was no doubt the safest bet. But at that time there was still plenty of legitimate prescriptions around and I could always get a few pills for longer hikes. My mother was my main supplier as the local pill mill still prescribed them to older people without much concern. She lived in something like an assisted living facility that was pretty much a drug bazaar for the elderly. A lot of those old people had become addicted and those who had been cut off were always bugging those who had prescriptions and didn’t use them. It was comical on the surface, but very sad beneath. Eventually, my mom died and doctors cut back even further on legitimate prescriptions, so most people in pain only had the fentanyl-laced black market to fall back on.
During those years, I constantly worked on my doctor to get a prescription. My strategy was to be totally honest, just like I described above, and he eventually came to trust me, and rightly so. I’m now officially on a pain management program and have a regular prescription. I broke a bone in my foot awhile back and now have mild arthritis in my knees and hip as well, so we can tick enough boxes for the insurance company to legitimize my pain. A one month prescription lasts me about four.
Although I benefit, I see that the pain management program is yet another example of the insanity that is our medical system, especially when politicians get involved. It requires random drug testing and any failed drug test gets a person kicked off the program. So someone suffering from horrible pain who uses a bit of cannabis will be denied life altering medication. Also, although it’s not as bad as it was in the pill mill days, they still overprescribe. If I took the amount I’m allowed, I’d have become an addict a long time ago. Basically, it’s insane, and should be medical malpractice, to prescribe opioids for chronic pain except in the most extreme cases, or if the patient is dying and addiction no longer matters.
The articles I listed up top all tie into those experiences.
It explains a lot that good experiences, especially those involving love or awe, release oxytocin, which is the body’s natural opioid, making happy people leading satisfying lives happier and more satisfied. It also helps explain why people who live lives severely lacking in love and awe might feel something akin to what an opioid addict feels when going through withdrawal, and why they would seek those good feelings through artificial means, even though for them it will only lead to addiction and worse despair.
The other side of our cultural insanity is that many more people would benefit from taking medication like I do, particularly those who haven’t had a lot of love or awe in their lives. There’s got to be some middle ground where people can get pain relief, whether the pain is existential or physical, without unnecessarily creating millions of addicts. Unfortunately, I don’t think American society is equipped to deal with intelligent solutions for these kinds of problems. It’s either too much permissiveness or too much punishment, usually the latter.
After thinking about those articles, I realized as well that I was taking opioids on just about every long hike or long bike ride I’ve gone on in the last 15 years or so. Of course I felt love and awe for the outdoors before that, and I don’t take enough of the pills to get high that way, but I can’t help but thinking the love and awe I have for nature has been subtly enhanced all these years. So going forward, whenever you see me write gushingly about this beautiful world we live in, you can have a little chuckle, or a different kind of little chuckle if you already think my constant blabbering about nature is funny.
And you know, on most of those long walks and bike rides I’m taking photographs. And the big photo projects I’ve worked on all included a lot of physical effort. And now that I think about it in this context, I think I can see something of that love and awe I feel for the world and many of the people in it in my photos. Or is that just my imagination? I’ve always thought that a good photograph (and maybe even a common one) communicates something deeper about not just the subject but about the photographer as well. I like to think my work largely reflects my deep love and appreciation for nature and humanity, and some of the many mysteries beneath the surface of this world and the people in it. But I realize that it’s quite possible that a picture of a tree is just a picture of a tree. Still, if it’s bullshit, it’s harmless bullshit and there’s nothing wrong with harmless bullshit when it adds to a person’s satisfaction in this world.
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