Medication Tolerance Frustration

I have is a very high medication tolerance. This frequently poses problems in my life. For instance, for my Dilaudid, my pain doctor wrote to take 1-2 mg every six hours PRN and to take a maximum of two doses per day. However, 2 mg barely touches my pain. If I have pain severe enough to give in and take Dilaudid (I will not take medication unless I absolutely cannot bear it), I must take 4 mg to have any effect. I do not get a ‘high’ from it (nor would I wish to). If anything, I might get a little sleepy, but even that is pretty rare. Last semester when I really struggled with dystonia, I used to take Stadol in class or before exams if necessary, and it never once negatively affected my cognitive functioning. I remained awake and alert, and generally received very good grades on my tests. I do not, will not, and have never abused or misused medication. I am not one to be risky and irresponsible like that, and certainly do not engage in illegal activities. I have experienced drug-induced cloudiness as well as drug-induced mania (SSRIs & anesthesia — WORST PERIOD IN MY LIFE), and I absolutely DESPISED every single second of it. I would not take medication to get “high” as I hate that loss of control that many apparently seek. I’ve never even been drunk. I cannot help the fact that my tolerance is so high. My genetics (and perhaps also a built tolerance) are to blame. There are multiple studies out there about the genetic mutations I have with metabolizing certain drugs, as well as research studies about redheads and their increased thresholds for drugs, alcohol and anesthetics.I see a doctor at a pain clinic, and she asks questions and asks me to share things with her– but I am too afraid to tell her that I need more help sometimes. I already have a 7.5 µg Butrans patch and PRN Dilaudid that I use at least once or twice a week… If I tell her that this patch does virtually nothing and that when I have to take Dilaudid, I use more than she recommends, I am afraid she will get upset or, worse, think I am a drug addict or abuser. Narcotic abuse is much more common than I ever thought. After a doctor told me that, I searched “drug seekers” on YouTube and found shows like “Untold Stories of the ER” showing various stories about patients feigning illnesses to get a pain medicine “fix.” Seeing how often doctors see such druggies makes me a bit less angry about being met with rudeness and suspicion in the past…but it’s still a problem. I wish people would just do what they were supposed to and stop making getting help so much harder for those of us who truly need it.

Syncope

Hanging off a ledge,

   The aching hole beneath my dangling feet

is waiting to devour me.

I try to scream, but my breath is caught

   as my fingers curl

     around slippery thoughts

     and jumbled words

and suddenly I’m falling–

   tumbling faster and faster

into the abyss

         until

       nothing.