There is a lot of evidence that drug use is inextricably connected to pain management — even if that pain is psychic, and not physical. As the opioid crisis in Massachusetts continues to rage, it is clear that there is also a profound connection between heroin use and the medical community's aggressive approaches to chronic pain management. Patrick Cronin's descent into heroin addiction seemed unlikely. Raised in a loving and supportive family, he played sports, attended church, and graduated both high school and college. And yet, seven months after graduating college, Cronin was so desperate for a high, he did something that he once considered unimaginable: heroin.
"I was so sick that day I said, you know what, I’ll never do it again," Cronin said. "I’ll just do it this one time."
By the time Cronin tried that first hit of heroin, he was already addicted to the prescription painkiller Oxycontin. He traces that addiction to a football injury. The doctor prescribed Percocets. They dulled the pain, but what Cronin also liked was the how they made him feel: stress-free. He convinced his doctor to refill the prescription ahead of schedule. Then a friend offered something even stronger.
"I was like, 'Yeah — I’ll take one,'" Cronin said.
Heroin — cheaper and easier to get — ultimately became Cronin’s drug of choice. At the height of his addition he had dropped fifty pounds, focusing exclusively on getting his next fix.
"When I was doing heroin, there wasn’t one person who didn’t start with Oxycontin," he said. "Not one."
Oxycontin was not always so widely available. Originally, it was reserved to treat chronic pain in cancer patients. Then doctors began asking more and more about pain.
Dr. Daniel Alford, an addiction specialist at Boston University School of Medicine, says at the same time the medical community began focusing on pain, drug companies began more aggressively marketing Oxycontin and other opioid painkillers.
"There was a time when we thought these medications were amazing and wonderful," Alford said. "We now appreciate they help some people but they’re not perfect. And they carry tremendous risk ... we don’t understand why some people develop problems for addiction and others don’t."
Alford says limiting pain medicine can be counterintuitive. But, he notes, especially for chronic pain, opioids don’t work half the time.
"If they’re not getting pain relief, that leads to them increasing their does on their own, self escalation which is quite dangerous — or there is continual demand or requests for increases in dosages," Alford said.
Cronin — who now works for the Massachusetts Organization for Addiction Recovery — believes what happened to him could happen to anyone.
"If you’re not getting proper education and proper conversations with your primary care physician, you have a serious chance of becoming a heroin addict by taking something that you need," he said.
Is the risk is there today just as it was 15 years ago?
"Worse," Cronin said.
That risk informs his work warning others about the link between stopping pain and starting addiction.
