The Opioid Solution and HIV: From the Frying Pan Into the Fire
By Dave R.
February 1, 2013
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This article is Part One of a two-part piece. Read Part Two, "Opioid Dependency: What's It Got to Do With HIV?."
"Pain is experienced by people and families not by nerve endings." -- Dame Cicely Saunders
A nightmare for some and a godsend for others, some people become addicted to opioids because opioids have become their recreational drug of choice, while others become addicted because their pain symptoms are so severe that they have no choice. Either way, a problem has arisen which threatens social stability in whole communities, especially in North America, and makes authorities unsure which way to turn.
You may see this as a "far from my bed" phenomenon but as I will explain later, many people living with HIV find themselves involved with opioids before they know it and have to live with the consequences of this sort of treatment simply because there is no better way of treating their pain.
First some statistics to highlight the scale of the problem:
Shocked yet? Actually these statistics were assembled before the current explosion in opioid addiction and abuse that has recently begun to hit the headlines across the western world. The figures, five years later in 2012, will be far higher; and the number of deaths and serious health problems resulting from both opioid prescription and the black market will now be alarmingly high. It's a problem that is almost unrecognised in its expanse, and a social time bomb that we still seem unwilling to acknowledge.
Still, why should this be relevant to people living with HIV? The answer is that many people with HIV are also chronic pain patients, something that is often overlooked when reading about the negative aspects of being positive.
According to The Well Project, many people with the virus have to manage chronic pain symptoms for the following reasons:
According to pain.com, in 2005, 8% of HIV individuals were on long-term opioids (especially Oxycodone and Tramadol) for severe pain, which was more than double the non-HIV population. However, the good news is that the explosion in opioid use since then has not been paralleled in the HIV population. This is possibly because opioids are prescribed for valid reasons to HIV patients and there is less incidence of recreational opioid use which has worsened the problem in the general population.
Before everybody writes in to say that they're fine and have never had a problem with the virus or the medication, please be reassured that you are some of the lucky ones. Of course only a certain percentage of people living with HIV will suffer chronic pain in one form or another but a significant proportion of those will eventually have no option but to start taking opioids as the only painkillers that will help. It's not a choice; some pain is so severe that it just doesn't react to over-the-counter medications, or medications meant for other diseases. Opioids, if used properly, are a very effective solution. The problem is that they are not always used properly, as the statistics above clearly show.
Recreational use of opioids could also be said to be the result of psychological 'pain': fulfilling a need to escape from the harsh edges in life (it could also be simply the well-known search for a kick that has got out of hand). However, recreational drug use and the reasons for its popularity are really subjects for other articles. What we need to know to arm both ourselves and people we know with knowledge, is that it gets out of hand when people don't realise how quickly and easily they can become seriously addicted.
So, with the facts out of the way, it's perhaps useful to illustrate the problem by giving some examples of what opioid abuse and the authorities attempts to crack down on it have been doing to people.
HIV, Neuropathy and More: Avoiding Becoming a Nervous Wreck
English but living since 1986 in Amsterdam, the Netherlands. HIV+ since 2004 and a neuropathy patient since 2007. I've seen quite a bit, done quite a bit and bought quite a few t-shirts if you know what I mean; but all that baggage makes me what I am today: a better person I believe, despite it all.
Arriving on TheBody.com, originally, was the end result of getting neuropathy as a side effect of the medication, or the virus, or both. I found it such a vague disease and discovered very little information that wasn't commercially tinged, or scientifically impenetrable, so I decided to create a daily Blog and a website where practical information, hints, tips and experiences for patients could be gathered together in one place.
However, I was also given the chance to write about other aspects of living with HIV and have now contributed more articles about those than about neuropathy. That said, neuropathy remains my 'core subject' although one which unfortunately dominates both my life and that of many other HIV-positive people.
I'm not a doctor or qualified medical expert, just someone with neuropathy and HIV who has spent the last few years researching the illness and trying to create information sources for people who want to know more.
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September 17, 2014 - Houston, We Have an HIV PR Problem: A Blog Entry by Dave R.
September 2, 2014 - I'm Positive, I'm on Treatment, I'm Undetectable, So Get Off My Case! A Blog Entry by Dave R.
June 23, 2014 - When Push Comes to Shove ... How Far Would You Go to Eradicate HIV? A Blog Entry by Dave R.
May 14, 2014 - The Painful Reality of Neuropathy: A Blog Entry by Dave R.
March 3, 2014 - The Bug Chaser's Tale: An Interview -- A Blog Entry by Dave R.
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