As a member of the National Safety Council communications team, I have a higher purpose. Being part of an organization with the mission “Eliminating preventable deaths in our lifetime” is a heady, if not weighty, responsibility. I hadn’t expected that my personal and professional lives would collide with my first major project. Prescription Nation, a report on the opioid crisis that I co-authored and edited, was published this week.
My dad’s opioid dependence started from an acute pain event. His dialysis port started to fail and had to be replaced. The primary care physician believed opioids were an effective and nonaddictive pain solution. A low dose of hydrocodone helped Dad handle the pain while his new port healed. This took months, and Dad developed a dependence on prescription opioids that lasted the remainder of his life.
I wish Dad’s doctor knew what I know now. Opioids are not as effective for acute pain as many over-the-counter drugs. Dad probably would have had better pain relief with cool compresses and Tylenol, an over-the-counter pain reliever that is generally safe for dialysis patients. (Incidentally, acetaminophen is added to many prescription opioids to boost their pain-relieving qualities.) Prescription Nation identifies prescriber education as a primary way to reduce the number of opioid prescriptions and the number of pills per prescription. Some states are even setting guidelines for prescribers that restrict the number of days for a first opioid prescription, and most mandate the use of a prescription drug monitoring program to check whether a patient already has an opioid prescription.
Dialysis is hard on a man in his late 70s. When heart failure set in and Dad ended up in the county hospital ICU, the hospitalist had a hard time controlling Dad’s pain. A daily regimen of low-dose hydrocodone pills had created dependence, and the maximum dose of morphine couldn’t control the added pain.
The second afternoon of Dad’s hospitalization, he whispered to me, “Come here. I need something from home.” I’d made a few round trips for Dad’s electric razor, favorite slippers and the like, so I figured there was one more creature comfort that might make his last days a little easier.
“In the drawer next to my bed, there’s a prescription bottle. Just bring me one of my pain pills. Don’t tell the nurse,” Dad said.
I said, “Dad, I can’t do that. The doctor said you’re getting the most morphine they can give you. If you take a pain pill on top of that, you’ll die.”
“I don’t care,” he whispered with his eyes closed.
Now two of us were in unbearable pain.
I told the doctor about this conversation and she talked to Dad. The pain med schedule was adjusted ever so slightly. The doctor, nurse and I held our breath as the morphine dripped into Dad’s IV. His blood pressure dropped precariously low, then rebounded just enough. We exhaled. Dad slept. My sister arrived. Dad died a day and a half later.
That was nearly three years ago. As I wrote and edited Prescription Nation, this memory flooded back. I hope this report inspires legislators to take immediate, serious action in implementing policies and regulations that will help reverse this terrible epidemic. I can’t turn back the clock for my dad, but I hope Prescription Nation will help others seek nonaddictive pain relief, avoid dependence, misuse, addiction and death.
