Pain and Diabetes, are they similar?

Kirsten Schultz wrote a terrific item last week in her blog titled “Not Standing Still’s Disease” about the use of opiates for pain relief. Her blog is well reasoned, very insightful and informative. I hope that after you read my blog you will take an opportunity to read Kristen’s blog titled

“Opiates for pain relief: what patients have to say”

In her blog she writes “recently there have been many discussions centered on opiates and other pain relief medication”; that is an understatement in the chronic pain community. Kirsten makes a point that those of us who use opiates for pain relief are often viewed as being drug addicted. Or maybe worse, that opiates are merely a gateway for ourselves or others to the illegal drug trade. I have not felt this kind of backlash as I seldom use these medications and am fortunate to have a kind rheumatologist who focuses his practice as much on pain management as he does on treatment of RA. Others in the chronic pain community are not nearly as fortunate. They often find themselves being blamed, shamed and rejected because of their use of opiate pain medications.

Parallels

What piqued my interest about Kirsten’s blog is the many parallels between the RA and diabetes communities. First, people who misunderstand type 1 diabetes have a less than educated understanding of the condition and how it is managed. Second, most in our community know of the shaming of those with type 2 diabetes. It is as if Type 2 diabetes is the fault of the patient.

I personally felt this shaming many years ago. It was not long after I started using insulin that an uninformed person commented that insulin is an addictive drug. I suppose if one were to say I cannot live without insulin and that I would fight to obtain insulin then yes, insulin is an addictive drug.

As a member of the RA community I also know that we find family, friends or co-workers often give us that jaded look when we talk about pain and the need for pain relievers. As if using these medications is a bad choice we are making. We often feel judged for the use of these medications and perhaps even more often we find that it is better to hide our use of these medications so as not to cause ridicule.

Silos of Self

One other common thing I find is that in both the RA and diabetes communities we look at ourselves only in terms of the silos in which we reside. We think we have diabetes and those with chronic pain need to fight their own fight. Or in the RA community we believe that diabetes is the fault of the person, their diet or weight. We might even engage in shaming the other community. Saying things like fat people get diabetes or look at the drug addict taking those medications.

I have news for all of us in both communities. We are fighting the same fight just with different names. When we make these remarks we are deepening the stigma against our own self-interest. If pain is not real and people in the chronic pain community are drug dealers, then I am dismissing their human condition. Just as if I say that only fat people get diabetes is dismissing the human condition that is diabetes. Both statements are the result which stigma attached to our condition and just because a stigma does not involve us, does not make it any less hurtful.

Fighting Stigma

Kirsten’s blog this week got me to thinking about silos. I suppose I live in two silos. On one hand I have had type 1 diabetes for almost 42 years. While on the other I have experienced intense RA pain that has required me to use opioids for management. What I found this week by thinking about Kirsten’s blog is that stigma surrounding chronic disease is not my stigma or your stigma it is our stigma. And here is the final thought, all of us need do what we can to overcome stigma no matter where we find it. The first step to overcoming stigma is the willingness to learn about others. I hope you will take the first step and read about RA, diabetes or any condition you are not familiar with. I bet if you do you will find far more similarities than you might imagine.

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Take away for February 21, 2016:

• A chronic condition is not a choice,
• People with different conditions have many similar concerns,
• Regardless of condition stigma is self-reflective
• Having a chronic condition is more than what we see on the surface