A McLennan County resident’s life was turned upside down by an inflammatory disease that attacks his spine and causes chronic pain only slightly relieved through the daily use of opioids.

With alarm bells ringing across the nation about the opioid-abuse epidemic haunting hospitals, police departments and families, the 34-year-old doesn’t often share that he takes the painkillers. He agreed to share his journey with Ankylosing spondylitis if he could remain anonymous.

He went to the doctor at 18 with back pains. A few years later, he was diagnosed with Crohn’s disease.

It wasn’t until he was 24 that the doctors discovered the real problem.

His spine has arched so severely he walks with a cane, staring at the ground. His neck is calcifying, preventing him from looking left or right, or up or down.

“It’s really hard for me, looking back at old Facebook photos,” he said, showing a picture of himself from years back. “That’s tough to see.”

Doctors have prescribed a variety of painkillers over the years, he said.

The disease can be overwhelming. He said he can’t hold a job, is on disability, and lives with his parents. He can rarely enjoy his favorite thing: going to the movies. A self-proclaimed “movie nut,” he said he had dreams of going to school to become a film editor. Growing up, he went to the movie theater 20 to 30 times a year. He’s lucky if he can go once a year now. He said the pain is too much to sit through a movie, much less handle the stairs or seats at a theater.

The disease is isolating, though he fights to see his friends when he can, he said.

A local bar has become a refuge. While he hasn’t had a drink of alcohol since 2010 due to the pain medications, he said he’s found a home-away-from-home where he sees many of his friends who frequent the establishment.

“I made a ton of friends, the best friends I’ve made in my life has been up there,” he said.

The pain clinic he attends is thorough in controlling painkiller dosages, he said. He has to perform drug tests, see a doctor regularly and submit to monitoring on a regular basis, he said. There is a lot of misunderstanding out there about how pain medicines make someone feel, he said.

“I take it and it’s like, OK, I can get up now and go take a shower, or I can take it and go to the bank and go to the store. I can take it and go see my friends for a bit,” he said. “My pain is so bad I have to have something beside my bed to go in. If I wake up in the middle of the night and I’ve really got to go pee, if I’ve been sitting for a long time my hip gets frozen up.”

He said he knows there’s a lot of talk about the opioid epidemic and fear of abuse. He said he just hopes people still remember some people need painkillers just to exist on a daily basis.

The opioid abuse epidemic was brought to life through a perfect storm of problems, said Dr. Michael D. Reis, chair of Baylor Scott & White Health’s family medicine department and chief medical officer for clinics in the region.

Drug companies advertised opioid medications to doctors under the guise the drugs were not habit forming, Reis said. Also, doctors are graded on how well they control a patient’s pain, he said. Inflating the problem is the lack of education on chronic pain in medical schools, he said.

“The fact is, opioid medications work great for acute pain, sudden pain: a broken leg or cut or burn. Opioids are perfect for the pain that just happened,” Reis said.

However, after 30 days on an opioid, a person’s brain and nervous system start to change, he said. Eventually, the opioid no longer relieves pain, he said.

Locally, McLennan County has sued opioid manufacturers and wholesale distributors, and area law enforcement agencies are considering equipping officers with a drug to reverse opioid overdoses.

Reis said he doesn’t want people to be afraid to take Tylenol with codeine if they burn themselves or have a serious injury. There is just no reason to stay on that medication past seven days, he said.

Once a doctor quits prescribing the medication, some patients look to the streets to fill the craving, he said. That leads to heroin, which is more potent and costs less, he said.

Physician education

Reis is working on an educational project for physicians at Baylor Scott & White that has been underway for about a year. The program reinforces the difference between acute and chronic pain.

There are many good doctors who have acted in good faith on bad information, he said.

Studies have shown that patients who receive prescriptions for opioids after a surgery or injury often have pills left over, Reis said. Leftover pills often get other people addicted.

Either a young person takes the pills out of their parent’s cabinet, or the adult gives their neighbor a pill when the neighbor gets burned on the grill or something similar, he said.

Baylor Scott & White is working to ensure physicians only give a seven-day supply of an opioid, Reis said.

The Waco Police Department’s drug take-back program is aimed at helping empty medicine cabinets, Waco police Sgt. W. Patrick Swanton said. Often when someone is found with opioids on them, they were not prescribed to that person, he said.

“The problem is that they are so accessible,” Swanton said. “They are prescribed to an individual and they make their way into the wrong hands.”

The matter can’t just be policed, he said. Proper parental supervision and a message from home that abusing drugs is not acceptable is important, he said.

The Waco-McLennan County Public Health District aims to educate residents on many issues, but it has not taken up drug abuse.

The health district deals with environmental health, epidemiology, and infectious diseases, said John Kinnaird, a Waco City Council member, and chairman of the health district.

“At this point, no, we have not had discussions about opioid abuse or drug abuse,” Kinnaird said. “At this point, I don’t think that’s something we have the resources at this moment to really spearhead.”

Kinnaird said he could see the health district fostering conversations between appropriate parties to discuss options.

McLennan County’s rate of prescription opioid distribution is higher than state and national averages, according to a U.S. Centers for Disease Control and Prevention. For every 100 people in McLennan County, 77 opioid prescriptions were dispensed in 2015. The state average was 59.8 opioid prescriptions per 100 people, and the national average was 70.6 prescriptions per 100 people, according to the CDC.

Cassie L. Smith has covered county government for the Tribune-Herald since June 2014. She previously worked as a reporter for the Beaumont Enterprise and The Eagle in Bryan-College Station. Smith graduated from the University of Texas at Arlington.

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