During the 2016 Super Bowl, I was taken completely off-guard by one commercial: a thirty second spot drawing attention to opioid induced constipation (OIC). The black and white ad was not promoting any drug in particular: It was sponsored by five pain related organizations to bring attention to this major issue for those with chronic pain who rely on opioids to reduce their misery. After it aired, I tweeted, “Wow. Attention on chronic pain in a #SB50 commercial. https://www.oicisdifferent.com/.”
However, the popular response to the commercial was not the same. There were many uncomfortable poop jokes since our society is embarrassed to talk about natural body functions like bowel movements. Most of the negative comments, though, incorrectly and discriminatorily deemed the commercial as contributing toward junkies and the “opioid epidemic” that the CDC has decided is destroying America. Public figure Bill Maher even insensitively tweeted, “Was that really an ad for junkies who can't shit? America, I luv ya but I just can't keep up[.]” I was fairly outraged at the popular reaction, tweeting in response, “Less than amused at the abundance of ridicule by Twitter followers for the OIC commercial. If you haven't been there, don't laugh. #karma” followed by “Also, not all opioid users are junkies. That prejudice is unacceptable when so many people are in chronic pain. #oic #sb50.”
I have blogged before that I see a pain specialist. I am not secretive about this fact because I want clients and future clients to know that I truly understand their pain on a level that many are blessed not to. While my first methods of approach to almost every health related issue are natural ones, I am more than willing to admit that natural healing has its limits. When those natural methods fail, I am grateful that there are drugs available to help make life more bearable. I do not judge others who need Western medical treatment either.
I am not a wimp about pain. My twins were born in unmedicated vaginal breech and breech extraction births. For those unfamiliar with the terms, breech births are when the baby is born feet or butt first rather than head first which is the norm in about 96% of births. A breech extraction is often done in twin births when the second twin is breech. After the first baby has been born, the doctor inserts hir* entire hand into a woman’s vagina and up past the cervix, grabs the second baby’s feet, and then pulls the baby downward so that the breech birth can complete with the baby being born feet first. This is not exactly a comfortable procedure, but I did it without drugs. During the labor for those same twin births, I was arguing medical studies with the doctor on call in between contractions. This is not something most women without epidurals can do at that point in childbirth because the pain is so overwhelming, but my ability to handle the pain allowed me to do so. In my planned homebirth with my 10+ pound youngest child, I labored by myself through ten centimeters, the time when pushing begins. While I was waiting for my then-husband to shower and the midwife, assistant and doula to arrive, I had to distract myself from the pain of back labor. So to do that, I worked on putting away clean laundry while I was in transition. Again, this is the point where most unmedicated women are incapable of doing anything but laboring, yet I am a woman who is able to mentally overcome a great deal of pain through determination and personal strength.
Despite my strength and ability to overcome the pain of childbirth without drugs, I cannot conquer the chronic pain of my ongoing health battles without drugs. To be sure, I use alternative methods including meditation, acupuncture, craniosacral therapy, massage, manual lymph drainage, chiropractic, energy work, an organic gluten free diet, and over the counter legal herbs to help minimize my pain. However, even after spending thousands of dollars each month on complementary methods which keep me minimally functional, it’s not enough. I still require several prescription drugs including an opioid to allow me to be able to do things like take showers, prepare food, get myself dressed, and sleep. Without the opioids, I have absolutely no quality of life and become suicidal due to the unbearable levels of pain. With them, I am able to keep my pain levels at a 5 out of 10 instead of being at an 8+ continuously. In order to completely be pain free, I have to take doses of drugs that render me very heavily spaced out if not unconscious; as a result, I am never pain free.
When I made the decision to go on long acting opioids 24/7/365, one of the major considerations for my holistic practitioners and me was the impact that pain was having on my adrenal glands. In an oversimplified explanation, our adrenal glands sit on our kidneys and are responsible for the hormones that guide us during the “fight or flight” reflex. For someone in chronic pain, the body interprets this as trauma and is constantly in the “fight or flight” response. The adrenals are being asked to do a job they were not created to do, and often they “burn out,” leaving a person deprived of hormones they need to get through every day. The body then begins robbing hormones from other glands (such as the thyroid and reproductive system) to create the necessary adrenal hormones to keep a person functional. There then is a cascade of health problems because one’s body is so depleted from constantly fighting chronic pain. My health care providers and I agreed that the damage I was doing to my endocrine system from the pain I was enduring was not helping my healing process. It was time for me to turn to a pharmaceutical solution for pain relief.
Unfortunately, most drugs come with side effects. Opioids are no exception. The almost universal reaction to opioids is constipation. When I switched between my first and second pain specialists, the new doctor asked me, “What are you doing for constipation?” It was not a “Do you deal with constipation?” question. He presumed, rightfully, that l like others had to battle constipation in order to take opioids. While my battle has never been as horrific as it has been for some others, I still must take action every single day to make sure that I have a daily bowel movement to keep myself functional.
So how do I approach opioid induced constipation? Full force, with determination. Anything less results in a great deal more misery for me. When I first began taking opioids on an infrequent basis, I would use psyllium husks to relieve constipation. However, after a while that began to fail as my body built up tolerance to them. The next place I turned was vitamin C. I had previously been taking vitamin C to assist my completely wrecked immune system. At one point, I switched between brands of powdered vitamin C. The old brand required one tablespoon of crystals for four grams of C. The new brand required one TEAspoon of crystals for four grams of C. Not reading the label carefully, I took one tablespoon or 12 grams of C. The result was that within 30 minutes, everything, and I mean EVERYTHING, in my bowels was evacuated. That’s a mistake one only makes once! However, it also demonstrates how powerful of a laxative higher doses of C can be.
For many years, magnesium was my next approach to handling OIC. Lyme bacteria and other parasites rob the body of magnesium, so it is something I almost always need more of. However, due to absorption issues, it’s difficult to get the amount of magnesium I need in me through oral means. When one hits bowel tolerance for magnesium, the result is loose stools. In the case of OIC, it means that magnesium can act as a natural laxative. However, more recently my body has started using even small doses of magnesium to rapidly kill Lyme creating additional unbearable pain, so I have had to abandon magnesium as a laxative for the time being.
My first pain specialist had recommended Smooth Move tea available at health food stores. However, I am using Get Regular tea which, despite its long list of herbal ingredients, simply tastes like a pleasant mint tea. A web search finds many other herbal teas designed to help with constipation. I am taking Vitamin C in conjunction with the tea, and the two together are very effective for me. At some point they may stop working, and at that point, I will switch to another natural means of coping with OIC.
The public response to the commercial discussing OIC is an indicator of why those with chronic health problems which create horrid pain are treated terribly by the medical system. Those who use opioids are indiscriminately labeled “junkies.” People with chronic pain are automatically presumed to be drug seekers who are addicts contributing the downfall of the so-called “War on Drugs.” Ironically, many of the football players in Sunday’s game will end up suffering from chronic pain after having put their bodies through such intense physical trials in their younger years, and many of them will have to use opioids for pain relief as well. For the 100 million plus people who live with chronic pain, opioids can make the difference between being in bed all day every day and being able to enjoy life. They are not used to get a high for the vast majority of those in pain. They’re used to try to be remotely human.
Like most of those who struggle with chronic pain, I am not a junkie. I am a mother who eats an organic diet and keeps a chemical free home. I am a woman with a Ph.D. who runs a successful business helping others find complementary means of healing. I personally decrease the amount of drugs I can take any time my body will allow. None of these are behaviors of “junkies,” or to use a more compassionate term, people with addiction problems. However, I deal with OIC just as millions of others do. While it might have caused “your Super Bowl party [to come] to an uncomfortable pause with a black-and white ad aimed at chronic pain drug users who suffer constipation,” the commercial was speaking on a wider problem about chronic pain and its daily impact, one that our society needs to accept and research rather than judge.
© 2016 Elizabeth Galen, Ph.D., Green Heart Guidance, LLC
*I use the words ze/hir as gender neutral singular pronouns.