War on pain: The other side of opioids

LOUISVILLE, KY (WAVE) - There are always two sides to a story. WAVE 3 News is taking a look at one that doesn't get much attention -- the other side of opioids.

The opioid epidemic always makes headlines from the perspective of those who are addicted, or lives lost, but what about the people who use prescription opioids as a means of treating ongoing issues?

Kate Caufield is a working mom and wife. Caufield juggles a lot, and one of the things she deals with is rather uncomfortable, restless leg syndrome.

"About four years ago became absolutely unbearable for me," she explained.

Restless leg syndrome is a disorder of the part of the nervous system that causes an urge to move your legs. Caufield wasn't in pain, but it was interfering with her sleep. Many nights she was only getting about three hours of rest.

She tried a number of treatments. Nothing was really a great solution to her problem. Things changed about three years ago after she visited the dentist.

"I went in to get a tooth pulled and they prescribed me oxycodone and I slept better than I slept in years," Caufield said. "I started researching online. When I went to my doctor and presented the information she said, 'Yes I have heard of that and I'm willing to try it.'"

For the past three years, Caufield has been taking a low dose of oxycodone and another medication, Mirapex.

"I think that people think if you take an oxycodone you get high, or if you take any opioid you get high," Caufield said. "I suppose that may be true for some people. That is not a feeling I have ever had. The only thing it does is calm down my legs and I can go to sleep, that's it."

Caufield said she can finally function. Getting her opioid doesn't come easy.

"They said, 'Well we have a contract you have to sign,'" she explained.

The contract isn't legally binding but it forces conversations.

"They can drug test you at any time," Caufield said. "You have to go back every three months for a medicine check."

There are other requirements, too -- some that her prescriber wants her to follow and others that are because of the law. Caufield gets it and knows why new guidelines are being put in place to limit the supply of opioids available.

Dr. Charles Kodner is a professor and doctor at the University of Louisville.

"As I always tell my students and residents, there are awful lot of people who abuse pain medications," Dr. Kodner said. "There are an awful lot more who don't."

The substantial majority of people who have misused prescription opioids never received them in a healthcare setting; they obtained them from family and friends, or bought them on the street.

No one's questioning the potential and proven dangers of opioid use for chronic pain and other conditions. But, we've heard from patients who are under a doctor's care, finding success and normalcy with painkillers.

Dr. Kodner said there are physicians who have stopped prescribing opioids.

"Some physicians chose not to do pain management at all," Dr. Kodner said. "I respect their decision, but it just means that the rest of us have to do that much more work."

"Physicians know they are being monitored they know the Kentucky board of Medical Licensure is monitoring them," Vice President of Medical Affairs for Norton Hospital, Dr. Jim Frazier, said.

At Norton Healthcare, they've created an opioid utilization committee to see how prescribers are prescribing.

"Opioids are not bad," Dr. Frazier said. "They are absolutely necessary for those who need them. The challenge is finding the right dose for someone who needs them and the right amount and ideally weaning them off. Patients need to understand that a little bit of pain is acceptable."

Dr. Frazier said when prescriptions need to be cut back, it needs to be done gradually and humanely. Being suddenly taken off of them can lead to other problems like suicide or a switch to street drugs.

Many patients who need the opioids end up facing a lot of stigma.

"Patients tell me all the time they feel criminalized for taking their pain medications because the medical systems and staff and institutions will immediately suspect them or look at them differently," Dr. Kodner said.

"There are people for whatever reason are abusing, whether it is because they were on a treatment plan that went array or because they have a natural tendency toward the illness of addiction," Caufield said. "I do think there needs to be things in place. My biggest fear is that they will say we just need to get rid of this class of drugs."

If that ever happens, Caufield said she will look at other options. She's just looking for a middle ground.

"There is other me's out there and there are other people that deal with chronic pain conditions," Caufield said.

Opioid prescribing guidelines and recommendations, as well as provider resources, vary by state.

The Centers for Disease Control published a guideline for prescribing opioids for chronic pain in 2016.

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