Doctor Game: Beware of chronic pain, a close cousin to suicide

By Medicine Hat News on March 11, 2019.

“He preaches patience that never knew pain.” These sage words were published in the Handbook of Proverbs in 1855. Or, as Shakespeare wrote, “They breathe the truth that breathe their words in pain.” Today, pain is the most common medical symptom that plagues mankind. But when does it kill?

The number of people suffering from pain depends on the source of data. Some reports claim 25 to 100 million have some level of pain, and over 10 million suffer from considerable pain every day.

Dr. Emiko Petrosky, at the U.S. Center for Injury Prevention and Control, analyzed data on 123,000 suicides. His report, published in the Annals of Internal Medicine, shows that one in 10 patients with sizable pain decided to end his life.

Top causes for suicide are cancer, arthritis and spinal pain. And 54 per cent of victims of chronic pain used a gun, six per cent chose opioid overdose. The underlying cause is a combination of depression and pain.

Several reports have stressed that suicide could be prevented if patients received better pain control and counselling. But some famous people treated at world-famous clinics have nevertheless ended their lives.

I’ve known patients who, in youth, never reached for a baby Aspirin, but later in life developed arthritis, back pain due to spinal stenosis or a malignancy. Whatever the problem, constant pain caused a huge, negative change in lifestyle. This is when patients realize that the ads on TV depicting speedy relief of pain resemble Hollywood fantasy, rather than reality.

For instance, opioid drugs may have little effect on pain and often cause severe constipation. Unfortunately, it’s a well-kept secret that high doses of vitamin C, such as Medi-C Plus powder and other brands, available at health food stores, easily cure constipation. If 2,000 mg (milligrams) at bedtime fail, increase the dose by 2,000 mg. at night until it works. And this natural remedy does not injure bowels.

Pain therapy is difficult for doctors who worry about increasing the dose of opioid for fear of addiction. This is when, if steroid injections and other treatments fail, patients begin to seek acupuncture, chiropractic treatment and other remedies.

I have great empathy for patients suffering chronic pain because I’ve experienced many personal failures in the treatment of pain. I’ve had MRI’s that failed to diagnose my pain, failed acupuncture, failed spinal decompression treatment, failed chiropractic Rx and failure from various types of cannabis that ease pain in some patients, etc. etc. Eventually, when all options fail, chronic pain day after day becomes soul destroying, and a close cousin to suicide.

So, what can you do before someone cries “enough is enough!”? People suffering from chronic pain show varying degrees of depression. After all, who wouldn’t be upset when pain is a daily companion?

Studies show that up to 75 per cent of suicides give warning signs to friends or family members. So, if someone you know is in pain, begins withdrawing from social activities, expresses a strong desire to die, starts to give away prized possessions, loses an appetite for food, starts to use alcohol more often, becomes restless, sometimes angry, or unable to sleep, think depression and make sure they seek medical help. And there is no greater flashing red light than the purchase of a gun!

I know well that patients suffering from metastatic malignancy reach a point where, knowing there is little hope for recovery, they plead for medical assisted death. They should be allowed this gentle way of leaving this planet.

But for others with unrelenting, but non-fatal pain, it’s easier to sympathize than predict when they will end their life. Some eventually decide it’s simply not worthwhile or productive enough to get up in the morning. But that final second before they pull the trigger and leave their family must be the most agonizing moment of all.

I find it amusing and ironic that a glass of Chardonnay, or a rum and diet cola provide more relief for me than any treatment doctors have yet prescribed!!

Shakespeare was right, “They breathe the truth that breathe their words in pain.”