In Pain : : a Bioethicist's Personal Struggle With Opioids

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A salvage situation -- Pain and drugs -- The swinging pendulum -- The opioid dilemma -- Abandoned -- Dependence and addiction -- What doctors owe patients -- Recovery -- Pain, drugs, and doing the right thing -- America's three opioid epidemics -- Epilogue: Making a difference.
A bioethicist's memoir of opioid dependence and withdrawal exposes the American health care system's failures at managing the use of opioids for pain relief and reveals the lack of resources and structures to handle the nationwide epidemic of opioid addiction.
"A bioethicist's harrowing memoir of opioid dependence and withdrawal--and a clarion call to challenge the status quo of healthcare and of medicine itself--[this book] reveals the lack of crucial resources and structures to responsibly manage pain in America. Travis Rieder's terrifying journey down the rabbit hole of opioid dependence began with a motorcycle accident in 2015. One month and several surgeries later, Travis was on painkillers around the clock. The drugs he received were both miraculous and essential to his recovery--for a time. But the most profound suffering Travis would endure arrived months after the accident, when he went into acute opioid withdrawal while following his physician's orders. Over the course of four excruciating weeks, Rieder experienced firsthand, all day long and through the night, what it means to be 'dope sick'--the absolute physical and mental agony that is opioid withdrawal. Clueless how to taper off these intensely powerful painkillers, Travis turned to his doctors, who suggested that he go back on the drugs and simply try again later. Rieder's experience exposes a dark secret of American healthcare: the crisis currently facing us is actually an unsurprising and inevitable consequence of a culture deeply conflicted about opioids and a system grossly inept at managing them. As he recounts his own brutal story of pain and pills, Rieder provides the fascinating history and trajectory of these drugs, from their invention in the 1800s through a long period of opiophobia to the eventual warm embrace of these medications that led to an environment of aggressive, even reckless, prescribing. Here rigorous examinations of the science of pain and addiction are considered alongside analyses of the systemic and cultural barriers we must overcome if we are to address the problem effectively on both a local and a global scale. [This book] is not only a gripping personal account of drug dependence, but also a groundbreaking exploration of the complex causes of our opioid epidemic and a path to resolving the crisis through provider education, policy, and alternative treatment advocacy. Rieder makes very clear that the opioid crisis exists against a backdrop of real, debilitating pain that providers cannot ignore but can learn to treat more effectively and safely. Pain management is profoundly broken in America, and the result is devastating for both patients and those at risk for addiction. But we do not, Rieder argues, have to accept this situation. By changing medical practice, adopting reasonable drug policies, and altering the way we view those who take drugs (both prescription and not), we can reduce suffering and save lives; we can give people the care they deserve."--Dust jacket.

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