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What a pain
Most people with HIV experience pain at some point, and pain can get worse as HIV progresses. Treating pain can be tough if you drink alcohol, use drugs or are on methadone. You shouldn’t have to live with pain, so try to get the medication you need.
Here are some problems you might run into:
- If you use heroin or take methadone, your pain tolerance may be much higher than other people’s. As a result, when your pain becomes bad, you will likely need higher-than-normal doses of pain medication. However, most doctors and hospitals tend to under-prescribe painkillers to people who use drugs.
- If a doctor assumes that your pain is related to your drug use, and not HIV, he or she may not treat it.
- Sometimes doctors don’t warn you that taking certain painkillers and opiates (like heroin) at the same time can cause overdoses. Try to raise this issue with your doctor. Since some painkillers interact dangerously with HIV meds, especially those called “protease inhibitors,” talk with your doctor about these possible interactions, too.
- Some doctors assume that if you’re on methadone you feel no pain, so they don’t give you enough painkillers. In fact, some people on methadone need very high doses of pain medication to feel better.
Since you want to avoid problems with pain management, it’s important to talk with your doctor clearly and openly about the pain and your drug use, so he or she can identify the cause of the pain. If you feel you’re being denied the pain medication you need, try to stick up for yourself, or bring along an advocate — such as a nurse from your local AIDS agency or needle exchange — when you see your doctor.
To prepare for your doctor visit:
- take note of all the places where you feel pain
- describe what the pain feels like — is it burning? shooting? sharp? sudden? lingering?
- describe the pattern of the pain — when does it occur? when does it feel better or worse?
- describe how bad the pain is on a scale of 1 to 10
- notice whether the pain gets better or worse after you take medication or drugs
- explain how the pain affects you — are you able to work? move around? enjoy things?
Many people with HIV use complementary or alternative therapies to help relieve their pain. Aromatherapy has been used to reduce muscle aches and generalized pain. Therapeutic touch, relaxation and imagery techniques may decrease stomach pain, joint pain and headaches. Massage, acupuncture and physical therapy can provide additional comfort. If you can’t afford these, you might find that simply relaxing, listening to music and using hot or cold compresses or muscle soreness ointments like tiger balm can help you feel better.
“There are things you can do with your doctor around pain management.
I worked out a contract with my doctor that I’d go to the pharmacy every day to pick up my morphine and take it in front of the doctor because he thought I was going to break it down and shoot it.
That was a legitimate concern, because I would have.
Then, as I started taking it every day, he gave it to me to take home once a week, then once every two weeks.
And so you build trust.”
—Cindy R. |
