An Open Letter to My (Currently) Med-Free Friends

Dear Med-Free Crips with Chronic Pain,

I truly appreciate your commitment to remaining med-free for as long as possible. Believe me, I completely understand why you don’t want to use pain medications unless absolutely necessary. As your friend, I hate it that you have to hurt at all, but at the same time, I’m happy that you’re able to avoid all of the negatives that go along with them. The stigma, cost, and side effects that come from using narcotics to manage chronic pain, while not as devastating as the pain itself, can still be heavy burdens to bear.

What’s harder for me to appreciate, however, are the arguments that being med-free is all about having a strong will, successfully using “mind over matter” techniques (e.g. positive thinking, “blocking” out the pain, distraction), and taking the more difficult path, and that it has nothing to do with how severe one‘s pain is.

Such statements are troubling not because of what they say about the people who don’t yet use pain medications, but because of what they infer about those of us who do: that we are taking the easy way out. That we are less focused and less disciplined. That we lack willpower.

I hope you can believe me when I say that I’m not trying to dismiss or make light of your pain, or how you choose to deal with it. What I am trying to do is help you understand is that it’s hurtful and insulting to have these negative, inaccurate inferences about those who need narcotics to manage pain brought up again and again, and that from my experience, the severity of the pain does affect how well those “mind over matter“ techniques work.

You see, I was once where you are now -- able to successfully cope with the pain that’s been my ever-present, unwanted companion for years without taking any medication. I kept busy, got adequate rest, and “talked” my body out of succumbing when the pain flared. I practiced all of the same things I do now -- controlled breathing, progressive relaxation, immersion in distracting tasks. And for a long time, I managed to get by.

But as time passed, the tools that I’d successfully used for so long became less and less effective -- despite spending more time practicing my breathing and relaxation techniques, and throwing myself into my work and hobbies, I was getting almost no relief, and the little bit that I did get wasn’t lasting as long. Finally, the day came when I wasn’t able to get enough relief on my own, and I had to accept that I now needed to use medication -- in my case, narcotics -- in order to have any quality of life. It was a huge hit to my self-esteem. I took great pride in my ability to use nothing but my mind to keep the pain from crippling me -- relying on pain drugs made me feel weak, angry, and embarrassed. I thought it meant I had lost my drive and determination.

But the more I thought about it, the less sense that made. My basic personality hadn’t changed -- I was still the same stubborn person with the same positive outlook on life. I was still able to use my “mind over matter” techniques to manage stress -- in fact, getting relief had become easier, not more difficult. And I knew in my heart that my decision to finally start using pain meds was anything but easy. The only possible explanation for this change was that the pain had become so severe that even my most skilled use of positive thinking or “blocking” couldn’t keep it at bay.

That’s not to say that I’ve abandoned those techniques now that I use narcotic pain meds. Quite the contrary, in fact -- it’s those very skills that now enable me to keep my use of pain drugs as low as possible.

And that’s why I have such a strong negative reaction when I hear you declare that being med-free is all about asserting mind over matter -- not because of what it says about you, but because of what it infers about me.