Living with Pain: Physician Abandonment and Suicide in Florida
by MARK MAGINN, COLUMNIST on JUNE 7, 2012
Last December, Joe Malone came home from work and found his wife, Michelle, dead from an intentional overdose of prescription medicine. She was only 49.
“I lost the person I loved most in the whole world. She’s never coming back. I’ll never be the same person,” Joe says of his wife’s suicide.
Like thousands of other pain patients, Michelle was a casualty of a war on drugs gone mad. The battlefield was Florida – a state that’s enacted tough laws and regulations to combat the abuse of opioid medicine. The crackdown has led to the needed closure of many pill mills, but it has so intimidated doctors and pharmacists – who fear losing their licenses — that many are denying opioid analgesics to legitimate pain patients.
Some patients, like Michelle, simply can’t live with the pain anymore.
Michelle and Joe Malone
It was twelve years ago, when the Malones were living in Middletown, Connecticut that Michelle was first diagnosed with Reflex Sympathetic Dystrophy (RSD), also known as Complex Regional Pain Syndrome. RSD affects the skin, bones and joints with searing pain.
Michelle learned that RSD was little understood and often treated with skepticism by doctors – many of whom are not adequately trained in pain medicine.
Like so many other pain patients, Michelle heard the most destructive thing a physician can say, “The pain isn’t real, it’s all in your head.”
RSD spread insidiously throughout her body, leaving Michelle in excruciating pain that led to despair, fleeting hope and recurring disappointment. She tried using opioid analgesics, such as a Fentanyl patch, but they only lessened her pain and did not stop it.
Michelle’s doctor recommended that the Malones move to a warmer climate. They followed that advice six years ago and relocated to Pensacola, Florida with all of her medical records and a referral to a pain specialist there.
Abandoned by Physicians
Michelle was referred to a well-respected pain clinic in north Florida, where a physician came up with his own medicine for pain, a formula mixed by a nearby pharmacist. This provider required all his pain patients, including Michelle, to discontinue all the drugs they were taking before they would be given this new medicine. Predictably, Michelle entered withdrawal as she came off the opioids too quickly.
As part of her treatment, Michelle was required to travel to the clinic weekly for an educational support group. It was a 45-minute drive from her home to the clinic. Michelle couldn’t drive herself and needed Joe to take her to appointments, but Joe couldn’t always get off work to do that. After a few missed meetings, Michelle was first warned and then dropped from the practice for failure to comply with the treatment plan. For Michelle, this was another in a line of physicians who abandoned her. Thoughts of suicide and a desire to stop the relentless pain increased.
“It really messed with her head, nobody wanted to help her. This is why she was depressed,” Joe recalls bitterly. “We had to rely on emergency rooms, but they treated her like shit, saying she was drug seeking, Not true. She only wanted relief.”
Like so many others inadequately treated for pain, Michelle’s condition deteriorated. She couldn’t work, do house chores or care for herself. Though often confined to bed, she developed insomnia.
“I would hold her up and we’d pace around the house for hours, it was the only way she could cope with the sleeplessness and pain,” said Joe.
Four years before her suicide, Michelle finally found a physician who understood RSD. Michelle saw her regularly and faithfully followed her medical orders and advice. Again, she relied on an opioid analgesic to lessen the pain. However much relief she gained from this treatment, it left her in lonesome anguish.
Michelle saw her physician for her regular appointment on December 16, 2011. According to Joe, she came home from the appointment to find a letter that explained to her in vague terms that her physician would no longer prescribe her medicine and would no longer treat her.
“You know what I’ll do if I can’t get my medicine,” she said that night in despair when Joe returned home from work.
Yes, Joe knew. Michelle had attempted suicide before, after other practices abandoned her.
Two days later, on December 18, Michelle took her own life.
Climate of Fear
There is a climate of fear and despair in Florida among pain patients who can’t get good medical care or have their opioid medicines filled in a timely fashion.
Yes, the public needs to be protected from opioid medicine abuse. But legitimate pain patients whose only relief comes from a combination of treatments that often entail opioid analgesics also need protection from the hysteria among the media, certain health care providers and politicians.
There are all too many reports of pain patients dying from complications of pain or from suicide. It’s not just despair that causes many pain patients to opt for dying. It is the only way many can think of to stop their agony.
What is so disturbing about what happened to Michelle and uncounted others in Florida and throughout our country is the cavalier abandonment of our most endangered patients. Michelle’s death was an entirely predictable tragedy resulting from our misguided war on drugs.
There are many resources available for people having suicidal thoughts, including a toll free hotline where counselors are available 24 hours a day. Family members or loved ones can also find tips about suicide prevention and spotting the warning signs of suicidal behavior.
Mark Maginn lives in the east bay of San Francisco where he is a poet, writer and social justice activist. Mark suffers from chronic pain and was a longtime volunteer with the American Pain Foundation. His blog can be found here.
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