The Independent

I need medicine to manage my pain – not art classes


Chronic pain pitches the sufferer into a foul hellscape in which the body becomes the enemy. For me, the worst of it is the neuropathi­c pain in my useless right foot. Think of a thousand tiny needles – each of them tipped with hot acid – constantly jabbing at you. Or having

someone hold you down before attacking your extremitie­s with wire wool or coarse sandpaper.

That’s far from the only unpleasant holdover from having had a cement truck run over me, which left me spending what felt like an eternity trapped beneath its wheels. I have an undiagnose­d source of pain in my left hip. My left arm, which is held together with metal, periodical­ly likes to remind me of its existence. So does my back.

I take a cocktail of painkillin­g drugs to deal with this, including some of those the NHS is increasing­ly leery of prescribin­g. Earlier this week, NHS England launched what it called a “new framework for local health and care providers” which “aims to further reduce inappropri­ate prescribin­g of high-strength painkiller­s and other addiction-causing medicines, like opioids and benzodiaze­pines”.

The framework includes serving up art or music classes for those suffering from chronic pain as alternativ­es to medication. Yep, if we all just sit in a circle and sing “Kumbaya” the pain will magically vanish.

The announceme­nt hailed an 8 per cent reduction in the number of opioid painkiller­s prescribed “which is estimated to have saved nearly 350 lives and prevented more than 2,100 incidents of patient harm”. The numbers of benzodiaze­pines and sleeping pills handed out in England have also fallen by 170,000 (13.9 per cent) and 95,000 (10.2 per cent) respective­ly since the implementa­tion of recommenda­tions outlined in a 2019 review by Public Health England.

And sure, if the drugs don’t work and lives can be saved through cutting them out, how could you not be on board with that? Well here’s the thing: sometimes the drugs do work. The debate over the prescripti­on of drugs to treat chronic pain caused me to ask myself a question: does this stuff work for me? Do I need it?

me I sometimes looked grey. But I was stubborn. I also reduced my other meds, then reduced them again.

I did all the things you’re supposed to do too. Distractio­n? I started working, nine months before my doctors predicted I would, steadily cranking up my output. I finished off an MA in the evenings. I went to see bands play live, I hauled myself to the cinema to see movies.

It’s hard to concentrat­e on writing when your foot is in an acid bath and your hip is saying ‘oi, you’re forgetting about me so I’m going to muck you up’

But here’s the thing: the meds actually helped with that. It’s hard to concentrat­e on writing when your foot is in an acid bath and your hip is saying “oi, you’re forgetting about me so I’m going to muck you up”, and your arm and back are queuing up to do the same. Music isn’t so enjoyable when pain leaves you gritting your teeth to get through a show you’ve paid 50 quid to get into. The same goes for movies.

Before writing this, I sat down to analyse what my medication was doing. Within maybe 20 or 30 minutes of taking it, the needles start to lose their heat and their acid, the sandpaper its coarseness. The wire wool became, if not cotton wool then at least something a lot less potent. The other annoyances eased.

The pain didn’t completely vanish. It is nearly always there to some degree. But it did become much more manageable.

Professor Stephen Powis, national medical director for NHS England, said this: “We know that patients who require prescripti­ons for potentiall­y addictive drugs can become dependent and struggle with withdrawal, and this new action plan helps NHS services to continue positive work in this space

having already slashed opioid prescripti­ons by almost half a million over the last four years.

“The plan gives clear guidance to support patients who no longer need these drugs to provide them with routine medicine reviews and move them on to other, alternativ­e therapies where appropriat­e, saving both lives and taxpayer money in the process.”

OK, great. But what concerns me is that hard-pressed GPs will see this as gospel and decide to cut all their patients off, including those for whom medication is working. I’ve spoken to pain consultant­s, pain sufferers, and even the occasional lawyer about this. They’ve told me this has already been happening, sometimes with deeply malign results. On occasion, consultant­s have written fierce letters to GPs. But what if you can’t get hold of your pain consultant? That isn’t easy in today’s NHS.

If you can’t, and the medication is appropriat­e, the result can be something like torture. And no, that’s not hyperbole. There is a strand of clinical thinking that appears to hold that pain is simply “in the mind”. This is a deeply obnoxious and patronisin­g view, but I’ve seen variants of it expressed with alarming regularity.

I hope that is not the case with Professor Powis. I hope he is willing to address the risk of people being left to suffer unnecessar­ily, which ought to be unconscion­able to a doctor.

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 ?? (PA) ?? There is a strand of c l inica l thinking that appears to ho l d that pain is simp l y ‘in the mind’
(PA) There is a strand of c l inica l thinking that appears to ho l d that pain is simp l y ‘in the mind’

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