Prince and Perils of Pain

I was stunned on April 21 when I heard the news that Prince was dead. I live near Atlanta, so word of his postponed performances, originally scheduled for April 7 but not held until a week later due to illness, was widely publicized in my area. Yet, the reason given for the postponement was that he had the flu, so I was shocked to hear that the 57 year old artist, whose songs have featured prominently in the soundtrack of my life, was dead. I was equally surprised when I learned that his death was likely related to pain.

As I person with rheumatoid arthritis, I’m no stranger to pain. This condition causes flares of extreme pain, swelling, and fatigue, on top of lower levels of these symptoms that I experience on a daily basis. When I watch footage of Prince performing, I’m amazed at what his body could do. I sometimes have a hard time just walking through the grocery store, so seeing his splits, jumps, and myriad dance moves is beyond me. While he always made it look so easy, I know firsthand the impact that movement and shock absorption has on joints. Therefore, what surprises me about his pain is not that he experienced it, but how well he hid it.

In the weeks since Prince’s death, accounts of a hip surgery, chronic joint pain, and use of opioid pain medications to treat the pain have surfaced.[1] Toxicology tests are being run to determine if the cause of his death was indeed from an overdose of opioids.[2] This is in the midst of growing public attention on opioid addiction. In March the Centers for Disease Control released new guidelines for prescribing opioids in an effort to decrease the use of these drugs by people suffering from non-cancer chronic pain. President Obama focused his May 14 weekly address on opioid addiction and was joined by hip hop artist Macklemore, who discussed his former addiction to prescription drugs.[3] Frequently citing the statistic that more Americans now die from drug overdoses than from traffic accidents, the dangers of opioids are getting more and more media attention.

However, what’s not always included in these conversations is the experience of struggling with intense pain. As a person who has used opioids intermittently during the 15 years I’ve been diagnosed with rheumatoid arthritis, I can attest that sometimes nothing else works. Opioids are my last resort when it comes to pain management, as I hate the side effects I experience when taking them. Often my brain feels like it’s wrapped in gauze, and I’m incredibly tired yet simultaneously restless and unable to sleep. I do not at all enjoy the way I feel on painkillers, yet this unsavory state is preferable to excruciating pain. In addition, I’ll note that I have used chiropractic care, acupuncture, physical therapy, magnetic therapy, topical treatments, over the counter pain medications, supplements, yoga, water therapy and healing touch therapy in an effort to control pain without the use of opioids. Yet, there are still times of severe RA flares when the only thing that works is a prescription painkiller.

I know that the death rates from opioid deaths are staggering and scary, and that the struggles of people addicted to prescription drugs are real and valid. I am not suggesting there are not dangers of opioid use or that these dangers should be ignored. However, I am hoping that when these issues are discussed, that the experiences of individuals living with extreme pain should also be examined. It is a huge loss that Prince has died, and a month after his death I continue to mourn his loss. Yet, as a person who has lived through severe pain, I understand the desperation that can lead one to rely on opioids, and in the absence of equally effective alternatives, I cannot say that he shouldn’t have used opioids. I imagine it likely that he was desperate to escape excruciating pain, and I cannot fault anyone for feeling that way or for using a tool to mitigate some of the pain, even with the tool comes with safety hazards.

Opioid treatment of chronic pain is a very complicated and complex issue. As scrutiny of prescription painkillers increases, I worry that the personal experiences of individuals living with chronic, intense pain will be overlooked, and that we will be left to suffer through pain without any relief. The dangers of opioids must be weighed against their benefits, and in doing so these benefits should not be discounted. It’s easy to recognize the dangers of pain medications. However, unless one has lived with chronic pain, it’s not always as easy to see the psychological, emotional, and physical tolls that the pain itself can take on an individual, and how miserable it can be to live in this state.

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