October 11, 1991


No patient should ever wish for death because of his physician's reluctance to use adequate amounts of potent narcotics.

Jerome H. Jaffe, pharmacologist, 1965

About 4 months ago, after I wrote the article that was published last week, my doctor switched me from the very pleasant narcotic that I described, to another narcotic that did not give me that good feeling. I took a single pill at about 7 P.M. and got an uninterrupted night of sleep. I can handle almost anything if I get a good nights sleep.

That went on for about three months. My prescription was running out, so I called my doctor. He was on vacation and the doctor who was handling his patients refused to renew it. I panicked. I counted the pills and reassured myself that they would hold out until he returned. It didn't occur to me that I was hooked. Couldn't I stop any time that I wanted to? When the pain stopped, I would stop. The logic escaped me that the pain didn't stop me from taking my afternoon nap without the help of a pill. On reading this, my wife tells me that she tried to point this out and that I told her that she didn't know what she was talking about.

I felt slightly woozy in the morning. It was like that feeling that you get when you get off a boat. I worried that I might have a brain problem. Still, the most likely explanation was the drug. The only way to find out was to stop taking it.

I decided to stop making excuses and to stop taking the pill --NOW!

That night, I took a couple of aspirin and slept for about an hour. Then I woke up and tossed and turned. My muscles ached. They felt like I have felt when I had a fever. I yearned for that pill that would stop the pain. Then I fell asleep again.

It's 2 A.M. I can't sleep, so I'm sitting in bed and writing. The aspirin has worn off. I am wide awake. My muscles are feeling more-or-less normal. My mind feels clearer. It is a subtle difference, but a real one. I'm beginning to feel sleepy. I hope that that was all that there was to it. It wasn't too bad; but then, I was only addicted to a mere 5 mg. of a narcotic, once a day. I fall asleep.

I am awakened by Lu's alarm clock. I had slept soundly until 6 A.M. The night is over and I have slept. I feel good; better than I've felt in 9 months. Part of that is a clear head and that wonderful feeling of accomplishment. I have kicked the pill! I have thrown away my crutches!

It is two days later and I have now had two nights of sleep without the benefit of an opiate. I feel different. It reminds me of when I kicked the cigarette habit; everything feels different; things smell better and taste better. It seems to me that life tastes better. Maybe that's because kicking a habit feels like a real accomplishment. Maybe it's because I now feel as if I am no longer ill. Maybe it's all of the above --and more.

You wouldn't expect much of a difference between taking 5mg. of a narcotic and taking nothing, but there is a very real difference. My energy level now seems greater. I now realize how my life revolved around on that pill. I would look forward to the evening, when I took my pill and the pain went away. The pain is a lot less. Since I no longer need the narcotic, I also no longer need the pain to justify it. Does it still hurt? Yes, a bit, but it's tolerable.

One problem with kicking a habit is that you have to change at least a part of your life. It's sort of like loosing a a part of your body; everything has to change. And any change, no matter how small is usually unwanted.

People take pain killers because they are in pain. The alcohol addict is in some kind of mental pain as is the drug addict. In my case, the pain was physical, the result of surgery, so it is considered more respectable.

The answer, if there is an answer, to drug addiction is to get rid of the pain. Sometimes you can't get rid of it, particularly if the pain is physical. In those cases the narcotic and the addiction to it is preferable to the pain; particularly if the pain is so intense that death seems preferable to enduring the pain. Morphine and its derivatives stop pain. If the dose is well regulated, a person can lead an almost normal life until either the pain goes away or he dies.

I used to believe that some people had to die in pain. That is probably not true. A person who is forced to endure pain should get a different physician. If I die of some painful disease, I expect to die a morphine addict, but I will not die in pain. That is a great comfort to me.

The solution to mental pain is much more difficult. Some learn to deal with pain; some learn to avoid it; some turn to drugs. Of those who turn to drugs, most find out that the drug, while killing the pain, does not solve the problems that cause it, and the drug causes its own problems. The pain caused by the pain killer can be worse than the pain that a person took the pain killer for in the first place.

Drugs of one kind or another are an integral part of our world. Under certain circumstances, being drunk is considered normal and being sober is thought of as peculiar. I remember thinking that a friend of mine, who wouldn't drink at a party, was antisocial. I don't any more. He knew who he was and what he was doing, and none of the rest of us did.

A majority of the population uses one or more drugs, either occasionally or habitually. It ranges from a cup of coffee in the morning or a sleeping pill at bedtime to a cocaine or heroine habit. There are people who get drunk or stoned occasionally at parties, and people whose minds are always clouded; people who really don't know, or care, who they are minus the drugs. There are people who are committing slow suicide with cigarettes. There are people who can't defecate without the help of a laxative.

Obviously some habits are relatively harmless and some are totally debilitating. Life is fraught with pain and suffering. Drugs can be either the solution or the problem, depending on how they are used.

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