Pro drugs! Drugs for me!

I am pro-drugs.

That’s right. All the “chemicals” (even water!) for me. All the unpronounceable names (spoiler: I can pronounce them. That was my favourite part of organic chemistry). All the warning labels. All the little pills.

Get them in mah belly.

(not literally. Some of them go into your blood vessels, or your muscle, and let’s be honest: the warning labels are not edible. Although I’m sure you could make a warning label out of icing. You could write “Toxic – Do Not Eat” in icing and that would be hilarious)

I’m not sure if this is an unusual stance. The rest of the world – or at least, those portions of the world with which I interact on a regular basis – seems to be outright anti-drug.

There are good reasons for this. Drug abuse is a real problem in the real world with real consequences and real awful crime and death and suffering. My custodial parent had (still has, by all reports, but we don’t speak) a substance abuse problem. It’s a fucking ugly thing to live with and to see, and she was functional. There was no vomiting or passing out. She paced herself. Like a pro. And it was still awful.

I’ve written another post about the anti-medication stance and how, since I am an evolutionary disaster, I interpret that stance as wanting me, personally, to be dead. This is coming from a slightly different angle.

This was inspired by the recent realisation that I have an interesting knee-jerk response when a friend has an even vaguely medical problem. I always want to help my people; I want to solve problems; I can step back and listen to a whinge if someone just wants a helpful ear, but my instinct – if someone is not feeling well – is to offer them drugs. Anti-histamines. Painkillers. Whatever I have on hand.

As it happens, I have a lot on hand.

I’m a walking pharmacy. A few months ago, the little snaplock bag in my backpack was stuffed with the following things:

  • paracetamol/acetominophen (for the U.S.ians out there)
  • ibuprofen
  • Voltaren (diclofenac)
  • Naprogesic (naproxen)
  • Telfast (fexofenadine – an anti-histamine)
  • Codral (cold and flu pills with pseudoephedrine)
  • Ibuprofen + codeine (over the counter – 10 mg codeine per tablet)
  • Paracetamol + codeine (over the counter – 8 mg codeine per tablet)
  • Panadeine Forte (prescription – 30 mg per tablet)

I also have a standing prescription for what I call “horse pill antibiotics” (Augmentin Duo Forte) in case of rapid abscess accumulation (and sometimes they come up fast), I keep Kwells (seasickness tablets) in the glove box (I don’t get seasick – they’re for dive buddies and Husband), and I have a stash of really good sleeping pills (two different kinds). My GPs trust me not to abuse any of these prescriptions or stashes, and I reward that trust by only taking these drugs when I think I really need them.

I actually don’t take most of these very often.

The hayfever (for which I take Telfast) only kicked in a few years ago. It turns out you can reach the ripe old age of thirty-two years with a sense of smug reilef that you don’t get hayfever, and then it can all fall apart in one bad pollen season. I usually only take the Telfast on high pollen days when I want to go for a run (my favourite running track has some lovely wattles planted nearby. Beautiful golden blooms like sunlight drifting down onto the track, such that everyone in a 50 yard radius swells up like a sponge).

The Voltaren, ibuprofen and Naprogesic have been kicked out of the stash as these belong to a class of drugs called non-steroidal anti-inflammatories (NSAIDs) and if you have Crohn’s, they can trigger a flare. I don’t have a solid diagnosis, so in theory I could take them, but I’d prefer to avoid it. The really frustrating thing is that they are really good for muscle pain (hypermobility) and period pain and general headaches. I do tend to wander around with Voltaren emulgel; external application is unlikely to cause me problems.

The plain paracetamol has been kicked out as it does basically nothing for me. If the pain is of the level and type that will be helped by paracetamol, I won’t feel it. I am not kidding. The only reasons for me to take paracetamol are (1) to amplify the effect of endone if I am in severe post-surgery pain or (2) to reduce a fever. In which case I am unlikely to be out and about, so I can just raid the bathroom cabinet – I don’t need it in my “walking pharmacy” stash.

But the Codral, Panadeine, Panadeine Forte and Telfast remain in my stash. If I do end up needing them, I tend to need them right now.

(as a side note, while I tend to offer people drugs, I don’t offer prescription drugs. I would never give someone Panadeine Forte unless they already have a prescription for it and have left theirs at home for some reason)

What all this means is that I am a self-medicator par excellence.

I am on regular SSRIs and the Pill as well. I don’t see antidepressants as a weakness; I see them as a great tool for preventing me taking a voluntary header from the third floor (they do not, however, do anything for my gallows humour, which continues to make people very uncomfortable). I take fish oil (for inflamed joints), multi-vitamins (long story), vitamin D, Metamucil and probiotics. All supplements have been recommended to me by medical professionals given my diet and weird digestive issues (and, in the case of Vitamin D, skin tone and the resulting tendency to avoid being out in the sun lest I burst into flames).

So it does hurt a little bit – just a little, even though perhaps it shouldn’t – when I see this constant message out and about in the world: “People take too many drugs. We should just have a good diet!” (kale will totally cure my autoimmune issues) and “I will beat this thing without medication because I am strong!” (because I am terribly weak for taking Zoloft?) and “People don’t face up to things these days, they just take drugs!” (I face up to agonising pain and then I take the drugs. In that order.)

Even Lily Allen – a pop artist for whom I do have a bit of respect – pissed me off with the lines “You’ve got a prescription, so that makes it legal / I find the excuses overwhelmingly feeble.” Well, fuck you, Allen. Fuck you in your self-righteous face. “Your daughter’s depressed / we’ll get her straight on the Prozac / he doesn’t know / she already takes crack.” Yeah, okay, that’s a possible contraindication right there – but are we saying that drug addicts don’t deserve to have their depression treated? I realise the issue is complicated, but fuck.

I am tired of hearing drugs and medications demonised. “Don’t take supplements, just eat a Healthy Well-Balanced Diet!” Well, brainiac, my digestive system can’t tolerate your well-balanced fucking diet, so I take supplements. That way I get to avoid agonising gut pain and I also get to not have a vitamin deficiency! So much win!

“You shouldn’t need drugs to be happy! Just meditate!” I am not certain this even deserves the kind of vicious response of which I am capable.

I’ve always felt this way, but it’s taken on a new spin recently.

The twist is this: pain.

I’ve had numerous surgeries for abscesses, and they always send me home with a stash of Panadeine Forte (see above). However, my pain tolerance is very high, and for whatever reason, I don’t have a lot of pain after those surgeries. The abscesses themselves are sources of agony. The surgery – if I can’t get an OR and end up having it under a local (there’s now enough scar tissue that this is no longer an option – I just stay in the hospital until an OR is available – but it used to be more of a toss-up, and I used to push for locals over generals) – is mind-meltingly painful. Post-surgery? No worries. Some discomfort, but mostly I’m fine.

So I ended up with high-dose codeine sitting in my drawer.

Every now and again – at first it was only a couple of times a year, but it’s more frequent these days – I would get agonising gut pain. Like being stabbed. It was bad enough to cause greying vision and falling over. My legs would collapse under me. On one memorable occasion, I’m reasonably sure that the only reason I didn’t pass out was because I was carrying a gel to be visualised, and goddamn if I was going to drop it and have to repeat an hour’s work when I was already in the lab at 8 pm. I am nothing if not bloody-minded.

It’s never been diagnosed (working on it). It’s not gallstones. It’s not kidney stones. It’s not any number of other things that have been checked. It just happens.

And, since I had them there, I took my Panadeine Forte for it. Codeine slows peristalsis (the muscular movements of your intestines, shifting partially digested stool around). This means that, not only do you experience the narcotic effect of pain relief, but, if your gut is the source of your pain, it will ease on a mechanical level. I felt horrendously guilty for using the prescription painkillers that had been prescribed for a different issue, but it was the only thing that helped. I would take them, and sleep for a couple of hours, and wake up feeling a lot better – sore on the inside, like my intestines were so much tenderised meat, and not wanting to eat much, but better.

That’s been the story of my Forte useage. In recent times, I would go to doctors and ask for a prescription, explaining with many disclaimers that I really only take it when I need it, because I was terrified of being labelled a drug-seeker. And that terror meant it took me much longer to be comfortable asking for what I needed.

Where did that terror come from?

Oh, that’s right. This demonisation of drugs, combined with having had a parent with a substance abuse problem.

In the not-too-distant past, before my chronic health issues blew up (the last couple of years), I could make a box of 20 last for over a year. I’ve actually had to throw out expired boxes. Even the most wary GP laughs when I explain how long a box would last me, and would then gently say that they’re not worried about my “drug-seeking” behaviour. This reassures me, but I still worry.

I’ve been reluctant to take them for a number of reasons. Firstly, the worry about addiction – I don’t have an addictive personality (I have an obsessive personality, but that’s not the same thing), but brain chemistry is brain chemistry, and chemical dependency is theoretically possible for everyone. Secondly, the fear of building up a tolerance: if these are the only readily accessible painkillers that work, I want them to actually work. I want my brain to gurgle and fall over when I take them.

Thirdly – and this is the interesting one of late – the issue of functionality. That much codeine makes me dopey and fuzzy. I am suffused with a sense of euphoric well-being, I think happily about how lucky I am to know the wonderful people that I do, and how nice my house is, and how pretty the forest is, and all this is quite pleasant. I also get sleepy.

Quite obviously, I can’t drive. I’m also not in a position to be able to write a paper or run an analysis. I certainly shouldn’t sign any paperwork in that state. I know that when I take the painkillers, I’m taking myself out of the usefulness stakes for a wee while.

This has changed recently.

I’ve noticed a very odd occurrence, recently, and it’s that – when the pain is severe enough – I actually concentrate better when full of codeine. I’ll recluntantly take my panadeine forte after much unhappy internal debate, feeling (however irrationally) like a failure for not being able to tough it out, expecting to have to work much harder mentally to get my work done, and I find that, hang on, now that I’m not in pain… I can stand up straight. I walk better. My muscle activation is better. Instead of being wonky, I walk in such a way that my physio and podiatrist would be hard-put to criticise my form. My core muscles do what they are supposed to. I can concentrate on what I am doing. Even though I am high on codeine.

This is because there is a point where chronic pain is so distracting, and so destructive, even though it’s not acute stabbing agony pain, that you can’t focus. You can’t get things done. You can’t move your body properly. I can actually be in this much pain for a while and not consciously notice, because of my wonky pain processing.

I am mesmerised by this realisation – that the pain is worse than I thought it was, and that sometimes I function better on prescription painkillers than off them. It is exactly the opposite of what I would expect. I’m finishing this blog post a few days after my surgery, and I’m currently on a full dose of forte, and it still hurts to sit up, but I’m able to converse, and concentrate, even though taking deep breaths is awful. I’m able to write, and structure sentences. I worry that this functionality is related to me building up a tolerance to codeine (and the fact that I’m still in pain might contribute to that conclusion), but it’s a strange eye-opener for me.

I don’t want to take the painkillers. I would rather not take them. It’s hard for me to admit I’m in pain, to admit that there is something about me that is so broken it hurts all the time. I have so many objections to taking them.

But that’s how it works for now. And all the fluffy, organic, natural-living, anti-“Pharma” rhetoric can’t take away my pain the way the pills can.

So I take them.

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