Before I had Complex Regional Pain Syndrome, I had migraines. Brutal days long migraines. They could last a day, a half a day, or a month. Sometimes several months. I tried a lot of medications to treat my migraines. Eventually, we settled on Imitrex nasal spray and occasionally a prescription for DHE.
DHE is a big bad migraine killer, it’s also just a killer. One of the things they used to make you do when they prescribed you DHE was sign a consent form, stating you had received counseling and information on the side effects of DHE. Otherwise, they stuck you in the hospital and gave it to you over the course of several days.
The reason for this, one of the known side effects of DHE is death. I’d sign the consent form and rush to the pharmacy to fill my prescription of injectable death. I did it without flinching, because migraines suck and when I’d had one for three or four months, risking death to get rid of it was okay with me…
Because death is a possible side effect of most migraine medications. Including the Imitrex Nasal Spray I was being prescribed. The majority of migraine medications work in one of two ways; they can constrict blood vessels or they can dilate blood vessels and the constrictors were the only ones that worked for me. Tests on my heart show it has some damage to it, they think I’ve had a small heart attack, I believe I was in my early 20s because I remember lying on the floor of my cubicle at work once and being sure I was dying. My heart felt like it was going to explode. I had weakness in both my arms. Trouble breathing. Dizziness. Sweating. Nausea.
And all I’d done was take a dose of Imitrex nasal spray. I hadn’t over used it. I hadn’t done anything particularly different with that dose. The side effects were brutal that day. And every day afterwards. Since that day, every time I take a dose of Imitrex or a dose of DHE, I have had intense chest pain. Eventually, I was taken off the Imitrex because the side effects were getting worse and put on a migraine medication that works via a barbiturate. That’s fun. Barbiturates, also known as Downers on the street, work by slowing down the central nervous systems signals. I use butalbita/acetamenophen. It’s great for migraines related to blood pressure, stress, tight muscles, and for whatever the hell causes my migraines. It works better than Imitrex ever did.
Supposedly, it creates feelings of euphoria. I don’t get that. I get sleepy, which is good, since I often get insomnia with migraines. It’s addictive. I am aware of that. Just one of the many fun side effects. Another one, it can cause death. Since it represses your central nervous system, it can cause one to spontaneously stop breathing. I think it would take either a great deal of the medication or it would take interactions with other medications or conditions to do so, but it is a risk.
Because there isn’t a medication out there that doesn’t carry risk of something, usually death or addiction. Hell, with the right traits, a person can get addicted to aspirin. Flexeril, the muscle relaxer I take, carries risk of addiction because it makes a person feel calm. It’s not physical addiction, it’s mental, but addiction is addiction. It can also kill you. One of the things I have learned in the last year is the Flexeril I take for jaw clenching/teeth grinding, and muscle spasms in my hip and thigh, is a common medication used in suicide.
The patient has to decide, is my condition severe enough to warrant my taking a medication for it? I’ve had to make that choice a lot since I was 19… I’ve been on Flexeril, Imitrex, DHE, Lyrica, Gabapentin, Klonopin, and Butalbital. Five of those carry risk of addiction. All 7 carry a risk of death due to dysfunction of the central nervous system or constriction of the heart and blood vessels.
All those years of dealing with migraines prepared me for my battle with CRPS. It may not seem like it, but it did. Prepared me for the pain. Prepared me for the medication choices I would have to take. Prepared me for understanding that misuse of a medication is the common cause of addiction to a prescription.
For the record, addiction runs in my father’s family and I am very familiar with it as a result. However, one of the things my father has preached most of my life is that we have to take responsibility even for our addictions. For me, this is the fact that I like soda a little too much and I enjoy smoking. I even enjoy the smell of cigarette smoke.
The point of this post was what? Oh, yes, all medications have risks. It isn’t just opiates that run the risk of addiction or death. Death is a more common side effect than most people realize. however, the moment you fill any prescription, you have made the decision that your condition requires the medications that may kill you. And patients should be required to take responsibility for that. It is tragic when someone does die because of the medication, but what was the alternative?
Going back to migraines, addiction and death rates are higher than the national average, but how much of that is because the condition itself is so brutal? Ask anyone with prolonged chronic migraines if the risk of addiction and death is worth it? Most of them will tell you that to get relief, they will risk both and not think twice about it. Medications like Imitrex and DHE are tools to keep life bearable for them, they won’t eradicate the condition that causes them to be needed. And next time they have a migraine, they will reach for the tablet that may cause them to have a massive heart attack or for the aneurysm they didn’t know they had to rupture, or for them to go to sleep and stop breathing and they will do it until they can’t anymore. Because that is the part that most people can’t fathom… Yes, there are risks, but the risks aren’t as bad as the condition treated.