Aired April 6, 1997 - 9:00 p.m. ET
(Aired again August 10, 1997 - 9:00 p.m. ET)
From CNN Interactive
Presented as public domain information
STEPHEN FRAZIER, IMPACT ANCHOR (on-camera): For this next story try to remember the worst pain you've ever felt and now imagine you feel it every minute, every day, year after year. That is life for millions of Americans. For some, there is a solution, a medicine so powerful it could not only relieve but eliminate pain, so old every doctor knows about it, but so misunderstood it is rarely prescribed. Time Magazine's Joelle Attinger reports now on the long held myths and the new proponents of morphine.
(BEGIN VIDEOTAPE)
DEBBIE SMILER, PATIENT (on-camera): Four cats, all want to go with us. Riding in the car just seems to be one of the things that my back and muscles can't tolerate.
JOELLE ATTINGER, "TIME" MAGAZINE (voice-over): Every few weeks, Debbie Smiler and her husband leave their home in a small town in South Carolina and drive 125 miles, two and a half hours, across the state line to Atlanta, Georgia. They have to because her local doctors refuse to prescribe the medicine she needs for pain, morphine.
DEBBIE SMILER: It's so far, of all the things I've tried, the only thing that gives me enough relief that I can function.
ATTINGER: Her pain is constant, the result of chronic fatigue syndrome and several abdominal problems.
SMILER: I have pain in parts of my body I didn't even know I had. Sometimes it's throbbing, sometimes it's like a knife, sometimes an aching. And it's just agony at times.
ATTINGER: Morphine, which comes from an extract of the opium poppy, is powerful enough to block the pain. But because it is potentially addictive, doctors usually reserve it and other narcotics for severe, short-term pain. But in recent years, some doctors have made a compelling case that morphine should be used more often. They say that narcotics can be prescribed for long-term pain and cause no harm, and they're not just talking about terminal patients. In some cases, they say, morphine can be used indefinitely.
If Debbie Smiler suddenly stopped taking her morphine pills, she would become violently ill from withdrawal. She is physically dependent on the drug. But her doctor at Emory University says she is not an addict.
DR. J. DAVID HADDOX, EMORY UNIVERSITY (on-camera): In an addict, quality of life goes down. In someone who is physically dependent on analgesic or pain-relieving medications, quality of life goes up.
ATTINGER: Addicts take drugs compulsively, to get high. Debbie Smiler doesn't get high. She gets relief. Addicts crave more and more of the drug. Debbie Smiler's dose is stable.
SMILER: And it's not as if I'm always thinking about, "Oh boy, look at my watch, when is my next dose due." I don't do that at all.
ATTINGER: Although research on the subject is not conclusive, several studies have found that the risk of addiction for pain patients is low. Even so, many doctors fear losing their licenses if they prescribe morphine. Other doctors don't prescribe it because they don't ask about pain and they think the patient's complaints are exaggerated.
There's a pervasive message in our culture that pain is good. "No pain, no gain," say athletes. In movies also, the good guy stoically copes. Remember Rocky? Real men go the distance and pain builds character.
JANE USINGER, PAIN PATIENT (on-camera): I'll tell you from experience, I did not become a better person.
ATTINGER: Jane Usinger's experience is typical of patients who fight an uphill battle against chronic pain and their own doctors. Her pelvis was crushed when a Chevy Suburban hit her while she stood by the door of her minivan. Nerves were damaged permanently. Physical therapy didn't help much, and despite six operations, searing pain bolted up and down her body like an electric shock.
USINGER: It can reduce me to sitting and rocking on the bed, crying, sobbing, curled up into a fetal position and just literally not knowing what to do.
ATTINGER: The only respite was a strong narcotic. But the doctors told her that they would cut off her supply after a few months.
USINGER: What was said to me was, "Look at your son. You don't want him growing up in an environment where his mother's a drug addict."
ATTINGER: She rationed her medicine for those days the agony was unbearable. She considered suicide.
USINGER: That's the closest I came to saying, "Hey, they're right. You know, maybe I shouldn't let my son grow up with a mother who's a drug addict. Maybe I ought to just get out of the picture totally." And that was really scary. I can't imagine anyone else raising my son.
ATTINGER: Jane Usinger's salvation was finding a doctor who prescribed, fentanyl (ph), a chemical cousin of morphine. From a skin patch, her body absorbs the narcotic gradually.
USINGER: A slow, steady dose. No highs, no lows.
ATTINGER: Relief was almost immediate. She was eventually able to adopt a daughter. Her son noticed she was no longer irritable all the time. USINGER: He looked at me and he said, "Mommy, are you my real mommy?" And I will never forget that moment. Tears just started streaming down my face, and I said, "This is your real mommy."
ATTINGER: Critics of the say yes to morphine approach warn of potential dangers. Will more drugs be diverted for illicit use if more doctors offer morphine? Will insurance companies promote narcotics over treating the pain's underlying cause? And how many doctors can accurately predict if a patient is at risk of addiction? For Jane Usinger, the risk was low and it paid off. Last summer, she carried the Olympic Torch through the streets of Atlanta. The nomination was anonymous. It may have been to recognize her years of volunteer work in charities, or perhaps, because of her personal triumph over pain.
USINGER: It was a feeling like the Phoenix who had risen, personally. And all those people cheering on the side, it felt like they were saying, "You did it. You came back." It was great.
(END VIDEOTAPE)
FRAZIER: People who advocate using narcotics for long-term pain emphasize that's not appropriate for every patient. There are other treatments and other drugs that should be explored before any doctor or any patient considers morphine.
ANNOUNCER: For more of this kind of reporting, read Time Magazine. The story continues on-line. Join our discussion after the program on the Impact Forum @ CNN.com/Impact.
FRAZIER: For IMPACT, I'm Stephen Frazier in Atlanta. Bernie.
SHAW: Stephen. And I'm Bernard Shaw in Washington. We'll see you next week on IMPACT.
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