Managing Chronic Pain in Sobriety

By Amy Dresner

01/30/12

As a sober addict prescribed Oxycodone, comedian Amy Dresner was careful to follow doctor's orders. Then her disease kicked in.

I had been back in the rooms for a year-and-a-half when I developed a devastatingly painful shoulder condition. My shoulder had been hurting for months, slowly getting stiffer by the day, and the pain became more excruciating as the weeks went by. At first I thought it was from my overly heavy beat-up Balenciaga handbag, laden with gum, lotion, business cards, tampons, change and lip gloss, that I religiously cart around. But I started to take my injury more seriously when I couldn’t raise my arm to the side or above my head: it was literally frozen. After a few misdiagnoses—torn rotator cuff and tendinitis—many X-rays and loud-banging MRI’s, I was eventually crowned with a little-known but incredibly painful diagnoses of “Frozen Shoulder.”

"Is that like cold shoulder?” fellow comics would joke. 

"Oh yes, but much bitchier," I'd reply.

While I'd heard about people going out on pain pills after years of sobriety, I rationalized that pills weren't my bag. 

“Frozen Shoulder”—or “adhesive capsulitis” as it’s known in the medical community—is when the shoulder capsule thickens and becomes tight; small adhesions form and movement is limited and painful. The cause is unknown, although it can also come on after a period of immobilization due to a surgery or fracture. But I’d had no injuries or operations. Had my chronic laziness finally caught up with me?

Whatever the cause, I was in agony. I couldn’t sleep because of the tight gripping pain in my joint on the cap of the shoulder radiating down my forearm. I was up every 25 minutes to soak in a hot bath or apply an ice pack. My days were spent rocking and weeping, downing so much Tylenol that my liver would cry out. You could smell me coming from a block away: I stank of Tiger Balm and Bengay.

I tried everything—acupuncture, massage, Cortisone shots, Novocain shots, topical ketamine cream, Lidocaine patches—and none of it worked. Finally, I consented to pain medication.

While I'd heard about people going out on pain pills after years of sobriety, I rationalized that pills weren't my bag. (I didn’t know then that you could always get a new bag.) “What's the worst that could happen?” I'd think. “I get addicted and have to get sober again?” No worries. I'd done it dozens of times.

So a sober doctor prescribed me the prescription drug, Norco, which is acetaminophen and hydrocodone. I hated it immediately. It was too short acting, the effect too heady and muddy. I’d always hated downers (I was an “upper” girl at heart) and this was no exception. Next: Oxycodone. My doctor knew I was a recovering addict and warned me that there was a chance I might get hooked. And even though I've never been lucky, the pain was so unbearable that I decided to take the chance. To be on the safe side, I handed the pills over to my husband and asked him to dole them out. While nobody I talked to thought this was a good idea, nobody talked me out of it, either.

When I’d been taking 45-75 milligrams a day for a month (which any real Oxy addict, by the way, will tell you is nothing), I went to see an orthopedic surgeon to see if surgery was an option. He refused, saying that I was too inflamed and that an operation would just make my condition worse. I told him that I was a recovering addict and that my internist had given me Oxy. "I would never prescribe you any narcotics—ever," he said.  As I left, he cautioned me, "Take it easy on the juice." At the time, I was offended.

When you are a former addict dealing with chronic pain, it is the most slippery of slopes. But aren’t addicts entitled to pain management? Just because we are in recovery, are we supposed to agree to excruciating agony without any aid? I was in hell for three to four months before I consented to pain medication. But the addict brain does funny things and early on, my husband began to see signs of dependence and abuse.

“How often are you taking the Oxy?” he asked.

"Every four to six hours as prescribed.”

"But you're not not taking them every four to six hours, either," he said. It was true. I was taking them every four hours. And then it became every three hours and 56 minutes. Then every three hours and 50 minutes. With each dose, I began shaving off a little time. 

My friend had her hip replaced at 37 and at the hospital they told her to "stay ahead of the pain.” That's all I was doing, right? But I began to feel like a fraud and stopped going to meetings. People would call me and ask me to speak and I would refuse. Then one day, I refilled the prescription and, when they gave me the bottle of 60 pills, I just never handed it over to my husband. Honestly, the thought didn't even occur to me. I guess that’s where words like cunning, baffling and powerful come into play.

The Oxy did ease my pain but the truth is, when that narcotic film between the world and me went up…oh, that slight apathy was such sweet relief. I was temporarily relieved of the sensitivity that always plagued me. I just didn't care. I probably should have known then that it was over.

The real problem with being a former addict on pain medication is that we quickly build up a mammoth tolerance to many medications. What worked for my pain in the beginning didn’t work three weeks in. We can also often have what is called a "paradoxical reaction” and, after a month or so, the opiates made me hostile and agitated instead of mellow and serene. And yet it was such a relief to feel different that I didn't care that I was only getting a shitty different. 

All I needed was one emotional event to push me over the edge of my attempt at control. One fight with my husband and I crushed up four of the Oxy’s and snorted them. I immediately puked. Then I tried to smoke one off of foil like I'd seen on Intervention. (Only addicts watch Intervention and instead of heeding it like the warning it’s meant to be, think, "Great idea! Fuck, I should have thought of that!") One night, I chewed seven, plus I was dipping into my one-hipped friend’s Percocet. I was in bed that whole weekend, sweating and jerking, achy and gossebumped.

I cut back to the three a day but even on just three Oxy, I could be monstrous. I was irritable. I wanted more.  The dragon in me had been awakened and three tiny pills did not satiate it. I Googled “How to inject pills” and came across a helpful but disturbing site that laid out exactly how to scrape the coating off pills to reduce them for intravenous use. But the recipe was too complicated. I can’t even cook an egg. 

When a second orthopedic surgeon also refused to do surgery but prescribed a muscle relaxant, I noticed the pain subside. I also noticed that under the guise of pain management, I had been rapidly wrecking my life: nodding off at comedy shows, throwing up in people’s cars. I had to get off this stuff.

So I did a slow taper, a medical detox. It was 10 days of all-over body pain, irritability, diarrhea and mania. But then it was over. And I was free. That’s when my friends confessed that my eyes had looked “dead” while I was on Oxy. And I had thought nobody knew.

When I emerged from my Oxy nightmare, I was in the second phase of Frozen Shoulder, where there’s much less pain but also much less mobility. I couldn’t raise my arm to shave my armpit in spite of physical therapy three times a week. But I slept like a baby and had no pain. Turns out I just had to wait for this thing to “thaw” before returning to my two-armed sober self. Waiting had never been my bag. But like I said, I didn’t know then that you could always get a new bag.