What We Lose When We Undertreat Pain | Kate Nicholson | TEDxBoulder

I was at the top of my game working as a civil rights attorney at the Justice Department when something happened that changed the course of my life I met my desk drinking a latte typing away on a document due to court when my back starts to burn it feels like acid eating my spine my muscle seize and throw me from my chair I curl on the floor my body sears with pain over the next few weeks the pain becomes constant I can barely stand sitting is impossible so mostly I lie down I commute lying across

the backseat of a car to work from a futon on the floor of my office and I use a walker to get from place to place for a while that works until one day my rides late I stand too long my legs go and I collapse I will be bedridden and in pain for almost twenty years later I learned the cause was a surgery when a doctor severed nerves in my spine the pain only appears when the damaged nerves grow back but try as they might the nerves don't repair they rewire but malfunctioned so a

light touch is a blowtorch when I shower fiery hot needles pierce my skin nerve pain intensifies it escalates like an alarm that gets louder and louder the longer it goes on the worse it gets looking back on it now the thing remember the most was the despair in my then husband's face this was a man who literally carried me in his arms from Doctor to doctor and then they told us there would be no cure that I'd never get better and would only get worse when all of this is happening I'm working as a civil

rights lawyer I'm arguing for the rights of people with HIV and AIDS to medical care for the rights of people who use wheelchairs to have meaningful work I guess the universe decided I needed some personal experience I became a person with a disability working as a disability rights lawyer and I loved my job I still had work to do so despite what the doctor said I decided to fight and that was a good decision I also made a bad one early on I refused to take opioids for pain I worried about addiction and stigma when

my doctors decided to stop treatments aimed at numbing and ablating the nerves and insisted on opioids I was shattered I felt like they were giving up that I was being put out to pasture drugged up and written off out of options I surrendered and swallowed the pills and then something remarkable happened I improved I felt relief I was a foggy space opened in my mind and I can work again and so I worked as a federal prosecutor for more than 20 years though I couldn't sit or stand or really walk for most of them I

negotiated groundbreaking settlements against the San Francisco 49ers and Giants and the Walt Disney Company while reclined on the right dose of pain medicine I want important cases in federal court arguing from a folding lawn chair once bedridden I drafted the current regulations under the Americans with Disabilities Act coordinated with the White House and supervised thousands of cases by hundreds of attorneys across the country all from my bed and when the pain finally improved I stopped taking opioids I wasn't addicted I did have to taper to avoid side effects it was a happy anti-climax now many

things healed me physical therapy meditation a medical device called a spinal stimulator the hundreds of people who brought groceries and dinner and companionship to my bedside for 20 years art but opioids were essential everyone experiences pain some of you are in pain right now and not just because you're anticipating three more hours in uncomfortable chairs for most people pain is temporary but if it lasts three months are longer pain becomes chronic and it changes from being a symptom to a disease according to federal statistics 50 million Americans have persistent everyday or severe pain like mine

that's one in six it's also significantly more than are affected by cancer heart disease diabetes or stroke 2.5 million people abuse opioids opioid abuse is devastating and in every news cycle and for the people affected and their families it's heartbreaking and poorly managed but our response as a society to opioid abuse is hurting the treatment of pain how a lot of the people who abuse opioids are using medication that wasn't prescribed for them they self-medicate with friends opioids by on the street some pose as pain patients and dr. Hopp so to stop abuse the law

attacks doctors physicians have been sentenced to up to 30 years in prison when their patients sold the opioids they prescribed there's a pain doctor right here in Boulder who's no longer in practice because of a drug enforcement agent who posed as a pain patient the perverse result of all of this is that fearing prosecution doctors today are reluctant to prescribe opioids even when necessary and appropriate when I first moved to Boulder I couldn't find anyone willing to treat me I had to fly back to DC it was expensive and painful and a long way to

have to go to the doctor but I could afford it what happens to people who can't and what about the news story we hear about someone in pain who goes to the doctor is prescribed opioids and becomes addicted it happens but it's relatively rare and somewhat preventable when people are screened for emotional pain and addictive patterns and then monitored after they receive opioids the risk of addiction comes down significantly but there are too few doctors who screen and monitor there are only a few thousand pain management specialists to treat tens of millions so most people

in pain go to the emergency room where there's no screening or monitoring none or they see their primary care doctor but there's a problem there too a lot of them weren't really trained in how to treat pain a recent Johns Hopkins study found a glaring discrepancy between the prevalence of pain and society and time dedicated to pain in medical school only for us medical schools had a single required course on pain so remarkably the number one reason people go to the doctor pain and the number one cause of long-term disability in America chronic pain are

under addressed in medical education that needs to change and we need to work with doctors not against them to expand treatment for both pain and addiction we need to educate ourselves about the dangers of sharing opioids with family and friends it doesn't help them it puts lives at risk and about proper disposal of unused medication we need to develop the next generation of pain medicine something that can't be abused but in the meantime with the heat turned up on the opioid epidemic let's remember that opioids also heal people they're the most powerful pain medicine we

have instead of denying suffering people relief a life let's properly medicate pain thank you [Music] you