Michael Jackson, King of Pain?

Details about Michael Jackson's passing are still fuzzy, but already people are drawing conclusions about the superstar's premature demise. One media thread has him using prescription medications in what may have been a troubling way http://www.huffingtonpost.com/2009/06/25/michael-jackson-prescript_n_221178.html, railing http://www.huffingtonpost.com/deepak-chopra/a-tribute-to-my-friend-mi_b_221268.html against the so-called "enablers" who made sure he had access to them.

Whether he had an addiction to prescription medications will, I suppose, come out in time. As storm clouds gather around the early, tragic end to what was surely one of his generation's most eccentric and gifted performers, I worry that the halo of celebrity will blind us to a problem bigger than whatever issues Michael Jackson may or may not have had with drugs. That problem is the plight of people in pain who use prescription pain medications for legitimate medical reasons.

I should disclose, before I go any further, that I am a consultant in the pharmaceutical industry, specifically to Purdue Pharma, the manufacturers of OxyContin. In an early, executive capacity for that company I became aware of the sad and inappropriate prejudices against people who use pain medications--opioid analgesics in particular--and the doctors who prescribe them. 20 years ago, I watched my dear late uncle, Arthur Master suffer unimaginable pain before finally succumbing to metastatic prostate cancer. I watched him bravely battle his pain, but when I asked his caregivers to prescribe more medicine, they declined. When I pressed, they said more might addict him. At that time I was unaware of the differences between addiction and physiological dependence, but even without special medical knowledge it was obvious my uncle would never leave the hospital and so the point was moot.

In the years leading up to 2004, still plagued by the injustice of lumping people whose intractable medical suffering together with drug abusers and addicts, I wrote my book The Truth About Chronic Pain, http://www.arthurrosenfeld.com/ArthurRosenfeld-TheTruthAboutChronicPain.html. It became a bestselling resource to patients and caregivers alike. Researching that book gave me a visceral understanding of the issues of pain and pain relief, and led me to understand the magnitude of the problem. Millions of Americans live in pain today. They are grandmothers with arthritis, 20-somethings who survive car accidents, your cousin whose toolbox fell on his hand, you waking up from surgery. They are our neighbors and family and friends. Succinctly put; pain patients are us.

Was Michael Jackson in pain? It is a matter of record that he had a high-pressure, perhaps abusive childhood. It is a matter of record that he suffered fears, obsessions and paranoia. Was his pain the sort of angst that leads some people to escape to from the world by abusing prescription medicines or street drugs? I cannot pretend to know. Did he suffer from a genetic predisposition to substance abuse? I haven't a clue. Did his doctor or doctors prescribe the proper doses of the proper medications in the proper combinations to treat whatever injuries or afflictions he may have had? I am not privy to that information either. Frankly I would never presume to judge another person's experience of life, their pain or their suffering or their choices. Judgments like that lead to the prejudices that plague our world.

What I can say with some regrettable confidence, however, is that if it turns out that prescription medications are in some way linked to his death, Michael Jackson's larger-than-life footprint will posthumously obscure the silent, tragic lives of millions of pain patients who make smaller, but no less important marks in the sand. I worry that instead of leaving a joyous, luminous legacy, the "Thriller's" end will bring more difficulties, more misunderstanding and more difficulties to the pain patients when they go to their doctor with a complaint or their pharmacy for a much-needed refill.

If such a maelstrom emerges over the next few weeks, please don't forget the intimacy of pain and the way it cuts through all stages and stations of life. Be compassionate. Don't join the nodding throngs who pass judgment on the suffering of others. Join me in mourning the loss of a musical genius instead. Crank up an MJ tune, and be happy that your body doesn't hurt too much to let you dance.

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Comments

[Pearlswan]

It seems to me that no matter how much money a person has, they cannot buy their own recovery with it because the system we all depend on to treat and heal only survives when it makes a profit off of a person's illness. So treatments become disease management programs rather than healing programs. When you heal someone, they get better and go away. No money to be made beyond the healing process. But when a person is told to manage their disease then profits continue for the life of the patient. Its a disease-care system, not a health-care system, hence the extreme dependence on drugs and medications instead of lifestyle changes that have the power to heal and return the body to health and balance. Michael Jackson's life was out of balance and it seems the preferred treatment was to drug him instead of to heal him. Money can't buy health. Money attracts medical leeches that stay in business by passing out prescriptions as treatments. "Heal the world we live in; save it for our children."

[Betts]

You didn't need to tell us that you are connected to Purdue. Your entire article, including all it's misleading information, could have been written by them. In fact, you seem to admit that you were "enlightened" by them, so all I can say is ; consider the source. If your book was written, based on the same junk science Purdue created in order to make thier billions on the backs of thousands of now addicted chronic pain patients and the tragic unwarranted deaths, it is a worthless. My humble opinion.

[John Chase]

It is impossible to determine whether a pain patient is addicted to the drug or to the pain relief the drug brings, except, arguably, in a clinical setting. The patient's doc can't make that determination, so we let it be made by the police and armchair readers who have never been hurt by our holy war on drugs? We are on a fools errand.

[GrainneKathleen]

My body currently does hurt too much to dance, so your post is of special interest to me. After a nerve injury, I have endured surgeries and dozens of treatments, as well as pharmaceuticals that I don't particularly like to take, but can make the difference between a decent day, and a fairly hellish one. Most of my doctors, especially my doctor at the pain clinic, are very understanding, and I am down to a much lower level of pain meds thanks to slow but steady healing and treatments. I couldn't even take drugs that would make the pain bearable for a long time because I don't tolerate opioids and many other medications well. I feel for everyone who must endure chronic pain (which is nearly everyone at some point or another) and I look forward o the day I am out of pain and free from drugs as much as I look forward to the day that we can treat pain in a gentler, non-addictive, more effective manner. Till then, there shouldn't be a stigma on those who legitimately take pain meds for their pain. We really need to put ourselves in the collective shoes of others who need relief.

[Arthur Rosenfeld - Huffpost Blogger]

You might find my April 14 post of interest, especially the section on legalization and the drug war. As for being a shill, I'm certain you're giving the folks who work with me a belly laugh, so thank you for the humor. Thanks too for reading my blog!

[OhTheHumanities]

Good enough for me, I retreat. You put more negative spin on your descriptions of the use of street drugs than on sanctioned pharmaceuticals, but coming out in favor of legalization will more than do.

[Arthur Rosenfeld - Huffpost Blogger]

You might find my April 14 post of interest, especially regarding the part about the drug war and legalization. As for being a shill, I'm betting the folks who work with me are having a laugh at that, so I'm grateful for the humor. Thanks for reading my blog!

[OhTheHumanities]

I'm sure as an industry consultant and painfully aware person you're doing all you can to support the legalization of medical marijuana, Arthur. Not that you mention it in your article or anything. Hey, people, keep an open mind, it doesn't mean Arthur is a shill.