In 2010, I experienced aggressive treatment for Stage 4 cancer of the tongue.  When a doctor says aggressive, beware. I knew trouble brewed when the nurse came in with my first round of chemo wearing a HazMat (hazardous material) suit. She donned not one pair, but two pair, of rubber gloves to handle the “medicine” already in a plastic bag to set up the IV drip.

The treatment left me hairless, emaciated and shaken. But it worked.  Early on, the doctors prescribed pain medication. I resisted. I let them know about my recovery.  They still thought I should take it; to stay ahead of the pain. I resisted. My years in recovery trained me to resist, that taking pain medication threatened my recovery. So, I resisted; until I could not resist any longer. The pain became too intense. Eventually, I ended up on three different types of narcotic pain medication just to make my condition tolerable.

The treatment left my mind jumbled and my moods erratic. One morning, I sat and sobbed on the couch. Sandy came in and gently asked if I had taken my medication.

“No.” I choked through my heaving chest.

She came back a few moments later with a tiny pill – oxycodone.  I held it between my thumb and forefinger bewildered how such a tiny tablet held so much relief and so much danger. Twenty minutes later, I felt fine! The sobs left, a wonderful feeling coursed through my body and I ventured out for a short walk.  As I walked, I became concerned. Perhaps, I enjoyed the powerful drug a little too much.

The next time I saw my doctor, I voiced my concern about the medication and my recovery status.  He look puzzled.  He replied.

“Why that’s the euphoric effect of the narcotic medication!”

“I know! That’s what worries me!”

The doctor saw the benefits while I saw the danger.  Then he said something that I initially dismissed, then gradually grasped the wisdom in the words.

“Simply take the medication as prescribed.”

As I healed from the treatment, I continued to take the opiate medication as prescribed, but I wanted to get off it more quickly than the doctors recommended. I did. And again I paid for it.  I shook, I quivered, I sweated, and I felt nauseous for a few days.  Afterwards, I told the doctor what I had done. He had a look of “why would you do that?”

I am grateful for the chemotherapy and the radiation.  The last nine years have been filled with wonder.  Yet there are still small costs to pay. Collateral damage remains. In 2018, I had four teeth removed (radiation and teeth don’t play well together). The sockets on the radiated side have not healed. When I looked up fancy terms like osteoradionecrosis (bone death) and osteomyelitis (bone infection) and temporomandibular joint (TMJ) pain, the definitions do not do justice to the pain associated with the conditions. In fact, through several rounds of antibiotic and increasingly large doses of ibuprofen, the pain escalated.  Fierce jaw pain often sent tentacles of fire behind my eye, into my ear or into my teeth. The intensity fascinated me. How was it possible that something could hurt like that? My regimen of ibuprofen stopped providing relief. A full nights sleep? Impossible.

I went back to the cancer center at the advice of my dentist, and after a battery of tests, cancer did not return. My cancer doctor, who I trust completely, became concerned when I described the pain. He prescribed 36 tabs of 5mg oxycodone. With hesitation, I filled the prescription. The instructions on the bottle say,

“TAKE 1 TABLET (5 MG TOTAL) BY MOUTH 4 TIMES DAILY (EVERY 6 HOURS) AS NEEDED FOR SEVERE PAIN”

The rules are clear, or are they? The amount (1 tablet) every 6 hours.  But what is severe pain? And do I need it? Some would argue that no pain is severe enough for an opiate.  Some would argue that no one needs an opiate.  I understand these arguments.  They occur in my head all the time.

At this point in my recovery, more than 31 years, and after several months of continuous discomfort, I talked with Sandy about my situation. At the time, Sandy managed some serious pain of her own, having suffered a brutal break of her shoulder.  I monitored her pain medication.  We agreed, she would monitor mine.

So six times over a two-week period, before bed, I took the medication. In my estimation the pain warranted the dose. The medication helped.  I slept.  I took the medication as prescribed. The only person who truly knew whether or not I used the medication properly was me.

Today, the jaw slowly heals, thanks to hyperbaric oxygen treatment. Yeah, I have to spend a couple hours in an acrylic tube every business day for 30 days, but it’s worth it. I’m taking a couple ibuprofen once every few days to manage the pain. The oxycodone sits in the bathroom closet ready to be disposed of soon. I use this story to make a point.

Recovery coaches are not doctors, yet we all have opinions about medication from a variety of perspectives.  All are valid.  One person taking a medication is not a threat to anyone else’s recovery.  Yet often recovery coaches feel threatened. Or concerned. Or judgmental.  Or dubious. Or righteous.  I’ve felt that way. I’ve had to manage my own stuff.

When a recoveree opens up the subject of pain medication, a few good questions to have in your toolbox are,

“How do you feel about being prescribed medication?”
“Talk to me about the benefits and concerns, if any.”
“Are you taking the medication as prescribed?”

In 2015, I finished a thruhike of the entire Appalachian Trail, a trek of 2,189.2 miles. It took 189 days and 6 pairs of boots. During all that time alone with my Creator, my purpose in life became more precisely defined. I am, simply, to coach recovery. Recovery saved me from an early demise and brought purpose to my tattered life. I have learned that I’m a coach to my very core. I am blessed to put the two together. I started work at the Connecticut Community for Addiction Recovery (CCAR) in 1999. I became the Executive Director of this recovery community organization in 2004. I have trained the CCAR Recovery Coach Academy© dozens of times and have a hand in modifying, improving and adapting various recovery coach curricula. I’m old enough now to start considering my legacy. This is a way for me to share things I have learned in my recovery, in my role as Executive Director and a trainer. I find that when I speak I present the same messages over and over. It’s time to write them down.

Phil “Right Click” Valentine
Recovery established 12.28.87

Phil "Right Click" Valentine

Phil "Right Click" Valentine

In 2015, I finished a thruhike of the entire Appalachian Trail, a trek of 2,189.2 miles. It took 189 days and 6 pairs of boots. During that sacred time, my purpose in life became more precisely defined. I am, simply, to coach recovery. Recovery saved me from an early demise and brought purpose to my tattered life. I have learned that I’m a coach to my very core. I am blessed to put the two together. I started work at the Connecticut Community for Addiction Recovery (CCAR) in January 1999. I became the Executive Director of this recovery community organization in 2004. I have trained the CCAR Recovery Coach Academy© dozens of times and have a hand in modifying, improving and adapting various recovery coach curricula. I’m old enough now to start considering my legacy. This is one way for me to share lessons learned in my recovery, in my role as Executive Director and a trainer. When I engage with others, I present the same messages repeatedly. It’s time to write them down.

13 Comments

  • Mike Barry says:

    Thank you for sharing extremely valuable information and a 1st person experience Phil.

  • Anthony Risi says:

    I am a sufferer of chronic pain of lmbarhip and leg. Injuries from an auto accident and from an assault leaving me in a coma in 2015. 11 surgeries and 19+ months of pt . Rather than continuing pain management and being prescribed various narcotic pain meds for myself to dispense i placed myself on a methadon program. Im dosed once a day with no opportunities to abuse the mdication. Methadone works well enough for me to use meditation and distraction techniques to manage pain. Some days are worse than others and I don’t sleep for 1 or 2 nights from it hurting. Sometimes weeks go by and notice no pain at all. I know at any moment I can make all my problems,pain Included, go away. My personal choice is to remain honest with myself about the pain. I choose to stay with a level of pain just to remind myself. To prove to myself I can continue on even with pain. I never let myself forget about myself. A year from now I will be someone who can be an example for someone. I choose to nurture this thru the pathways at CCAR . It started the day i told a guy i grew up with,” i cant do it by myself”. We known eachother like 30 yrs. Been thru stuff . Known all the same people He turned out to be a CCAR coach. I never knew. Now i do.

  • Joe Graziano says:

    Phil, I am a huge fan of your posts. You continue to inspire me everyday. This post was particularly impactful, and thank you for continuing to share your experience with all of us!!!

  • rick baldwin says:

    I have a big strong friend currently suffering from an infection & a lotta pain.
    He has the same worries as you, but with only 5 years sober, very scared of where meds could take him.
    I told him to pop those pills as needed since he is still in St Francis; we’ll worry about what to do when they throw you out.

  • richard pacukonas says:

    Personal honesty and compassionate accountability to another will prevent abuse and relapse. No one can, or should, have to live in severe pain. “Take as prescribed” is medical-speak for what the Program calls “Follow directions.” When we’re lying, to ourselves or others, we’re dying.
    All I’ll I’ve got to say is SOMETIMES – thank God for drugs!

  • Thanks for sharing your story of pain. I am glad and grateful you got through your medical crisis. Peace and blessings.
    Karen

  • I would suggest that methadone is excellent for pain and addiction – but it is prescribed different. But methadone for addiction has an excellent property that is not understood well (pain prescription has a partial effect). It’s called Narcotic Blockade and works when a significant number of the opiate receptor mu 1 (ORM1) are filled. Methadone also has a high affinity for the ORM1 and a long half life – 36 hours to be exact. However methadone only produces about 6 hours of analgesia. One added feature is it protects the patient from overdose. So to protect someone in recovery they should be on a blockade dose this will block euphoria but not analgesia – it should provide some pain relief. Other opiates can be prescribed to get through tolerance – they are protected from overdose and the euphoria.

    As we age the likelihood of needing pain medication increases. Methadone is good for full aching pain and nerve pain. It is not good to use methadone for pain management because the dose will need to be increased quickly for relief – rather it works as a euphoric blockade because strong pain medications will probablt ring your bells and that is what you need protection from. One of the major causes of relapse is stress and disease and pain fit that bill well.

    In the end every person in recovery has to make their own decision in discussion with their doctor.

    From the NAMA Recovery website.
    http://www.methadone.org/namadocuments/es09pain_management.html

  • Reiki Girl says:

    Hi, Right Click –
    Thank you so much for sharing your story, you have certainly been thru a lot. When the subject of pain meds come into coaching conversations, the only question I am really concerned with is “are you taking it as prescribed.” The second question is “since you brought it up, how is it affecting your life (thoughts, feelings, actions)? ” I think this conversation is a needed conversation, if the peer brings it up. If people are in recovery and need pain meds, there should be no stigma against this. Thanks, again, for your story, Right Click. As always, you tackle the tough issues and your stories resonate with many. !

  • Bill Michelotti says:

    Great article again Phil! “As Prescribed” are the key words here. I also recommend a relative hold and dispense the meds. I can attest through personal experience that if dosed properly, opiates will take the edge off of the pain and make it tolerable…without the euphoria. However, be aware and prepared for the possible depression and anxiety of withdrawal.

  • Ruth Riddick, CARC-RCP says:

    Very important post, Phil – thank you! “Severe” is indeed a subjective reckoning. When I faced the pain dilemma, I turned to five women whose sobriety I admired and asked if they would act as a Medication Accountability Team. They agreed. I checked in with each of them every day to confirm that I was taking the opioid as prescribed. This process continued through the period I used the pain relief and my fracture healed. Their generosity supported me through all the self-talk and second-guessing and fear of falling into a new addiction. I share this story on every occasion when it might be helpful, as I now share it here. This stuff is serious, but life happens and, if we stay mindful of the issues and ask for help, we stay safe – one day at a time.

  • Lawrence Riddick says:

    Thank you for sharing your story. My pain is more mental than physical though I do have some medical complications. I have over 30 years of recovery but feel that I have done nothing with my degrees and certificates ( BA, MPA, CASAC, CARC and CRPA-P).

    I am taking medication for depression but I am beginning to become concerned for my Recovery. I am in a quagmire but your story inspires me to maintain my recovery and approach life one day at a time.

    Thank you

  • DC says:

    Please say “THANK YOU” to Phil Valentine for his personal account of having to use pain medication.
    As a person in recovery, I feel educated, empowered, and able to ask those important questions to anyone, including myself, prescribed pain medication.
    CCAR has changed the lives of many and Phil Valentine continues to support us with his personal story of recovery from all issues life throws at us.
    Thanks again!

  • Patty K says:

    Hi Phil,
    Good article-
    I need pain meds sometimes and at 71 years old I take them when needed and as prescribed.
    And I stopped calling them dope- I call it medicine-
    I have put off a back surgery with yoga, stretching and the occasion pain med-
    19 years working a good program helped- and taking them with my sponsor, my doctor and my HP gave me the accountability I never had before!
    Good to see your name!
    I miss serving with you!
    Peace,
    Patty

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